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Diabetes: Basic Care

Regular tests and vaccinations can help you stay healthy and prevent problems caused by your diabetes. Ask your doctor about what care you need and what to expect.

A1c
This blood test checks your average blood sugar for the past 3 months. It can help keep track of long-term control of your blood sugar levels. Most doctors think the A1c test is the best way to see how well you are controlling diabetes. You may get tested when you are first diagnosed with diabetes and then 2 or more times a year after that. You do not have to go without eating before getting an A1c test.

Foot inspection
Over time, high blood sugar can damage the nerves in your feet and blood vessels all through your body, and affect how well you fight infection. Treating a minor foot injury early can keep it from becoming a serious problem. Inspect your feet at least one time a day with a mirror. If you cannot see well, have someone help you. Check for discolored skin, blisters, peeling or broken skin, corns, calluses, moisture, sores, and ingrown toenails. Note any areas that tingle or are numb. Ask your doctor to check your feet during each visit. He or she may notice a foot problem you have missed. If you have any questions about a foot problem, call your doctor right away.

Your hands also can be easily injured. To protect them, use pot holders and avoid hot water when cooking. Always check the temperature of your bath or shower with a part of your body that has normal temperature sensation, such as your elbow. Do not use your feet to check the temperature.

Foot exam
You'll need a foot exam by your doctor at least one time a year. Your doctor will check whether you can sense light touch or pressure. If you cannot feel anything in certain spots, you may be at higher risk for a sore (ulcer) on your foot.

Dilated eye exam
Everyone with diabetes should have regular eye exams (also called dilated retinal exams). Diabetes can lead to eye problems that cause vision loss or blindness. By the time you notice any vision problems, your eyes may already be seriously damaged. This exam can help detect symptoms early, and early treatment may help protect your vision. If you have diabetes, have this test every year, or more often if your doctor says to. If your eye exam results are normal, your doctor may consider follow-up exams every 2 years instead of every year.

Cholesterol and triglyceride test
Your doctor will want to routinely check the amount of fat, or cholesterol, in your blood.
High cholesterol raises your risk of a heart attack and stroke. People who have diabetes are at high risk for heart disease. And a person who has diabetes and high cholesterol has an even greater risk. The level of triglycerides, another type of fat, may be higher in patients with diabetes. This may cause serious problems such as damage to the pancreas (pancreatitis). The link between high triglycerides and heart disease is not as
clear.

Albumin test
This is a urine test that can detect kidney damage caused by diabetes. Microalbuminuria means you have small amounts of albumin in your urine. This is an early sign that you may have a problem with your kidneys. You may need more than one test to find out how well your kidneys are working.

The American Diabetes Association recommends yearly urine tests for people with diabetes.

  • With type 2 diabetes, you should have the test when first diagnosed, and then each year.
  • With type 1 diabetes, you should have the test each year starting 5 years after diagnosis.
  • If you have either type of diabetes and are pregnant, you may need testing.

Your doctor also may want to measure how well your kidneys are filtering blood. This is called glomerular filtration rate (GFR). Your doctor may give you a yearly creatinine test to estimate your GFR. Creatinine is a chemical that builds up in your blood when your kidneys are not working well. Your doctor may have you collect your urine for a 24-hour period.

Dental exam
If you have diabetes, you need to take good care of your mouth to avoid problems such as infections or gum disease. Have a dental exam every 6 months, or more often if your doctor or dentist says to. If you have any problems with your teeth or gums, talk to your dentist.

Vaccines
Certain vaccines are recommended for people who have diabetes:

  • Flu shot
    A yearly dose prepares your body to fight the flu (influenza) virus if you are exposed. If you are older or your immune system is not working well, the vaccine may not work as well. But even if the vaccine does not stop you from getting the flu, you may not be as sick if you do get it. People who have a long-term illness like diabetes cannot get the nasal spray vaccine instead of the shot (injection). The spray can cause the flu if your immune system is not working well.
  • Pneumococcal vaccine
    Two different types of pneumococcal shots are recommended for people ages 65 and older. People younger than 65 may need only one type of vaccine. People with diabetes, especially those with heart or kidney disease, are at high risk for serious problems, hospitalization, and death from pneumonia. The pneumococcal vaccine may not keep you from getting pneumonia. But if you do get pneumonia, you probably will not be as sick.
  • Hepatitis B vaccine.
    Three doses of this vaccine protect against hepatitis B liver disease. The hepatitis B virus is easily spread through contact with the blood or other body fluids of an infected person. This vaccine is recommended if you are younger than 60. If you are 60 or older and want this vaccine, talk with your doctor.

The information contained in this article is for informational purposes only, and does not constitute medical advice, diagnosis or treatment.

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