There is more to diabetes than just the day-to-day things—eating healthy, exercising, taking our medications, and testing our blood glucose. Those living with diabetes need to keep up to date on different testing to try to avoid complications that come with the disease. Some of those tasks can be completed on our own at home while others need to be completed with the help of a doctor.
While we know our blood sugar readings throughout the day are important for helping us manage our diabetes from one moment to the next, our A1C is important for us and our doctors. Our A1C is tested through a regular blood test, completed every 3 or 6 months depending on what your doctor recommends. It gives your doctor an idea of how well you have managed your diabetes over a 3-month period. The general guideline for those with diabetes is to have an A1C that is 7 or lower. It is recommended that you talk to your doctor about what number they suggest for you, as it can be different from one person to another. When your doctor knows your A1C level, it allows them to make adjustments to your medication(s) and make other suggestions about managing your diabetes.
The biggest complication of diabetes is heart disease. It is important to check your blood lipids (fat) and blood pressure. Your blood lipids and cholesterol should be checked at least once a year. If you have high cholesterol, this may be completed more than once a year. Your blood pressure should be checked at each visit with your doctor, but it may be recommended that you check at home too. You can purchase blood pressure monitors at many pharmacies, grocery stores, large retail stores, and online. If you have cardiovascular risks or problems, your health care provider may want your blood pressure to be less than 130/80, but you should talk to your doctor about what would be best for you.
Living with diabetes increases our chances of other diseases, like kidney disease and infections. At least once a year, your doctor may check your kidney function by means of a blood and urine test. It’s important to make sure your kidneys are functioning properly so they can filter your blood from waste and toxins. It can be helpful not just for kidney health but overall health to make sure you are up to date on your vaccinations. Due to an increased risk of infection and more severe symptoms, you should get a yearly flu shot. Other vaccinations to discuss with your doctor include pneumonia, Hepatitis B, shingles, tetanus-diphtheria-pertussis, measles-mumps-rubella, human papillomavirus, and COVID-19. While your primary doctor can monitor much of your health, it is also important to see dentists and optometrists.
Do you know that sometimes diabetes is first detected in the eyes? Your blood sugar can affect your eyes, so it is important to have your eyes checked once a year (or as recommended by your doctor). Your eye exam should include a dilated eye exam, where eye drops are placed in your eyes. Diabetes can cause diabetic retinopathy, glaucoma, cataracts, and other eye diseases. Symptoms may include blurred vision, floaters, dark areas in your vision and even blindness.
Another important visit for everyone is your dentist. Your teeth and gums should be checked at least twice a year or as recommended by your dentist. High blood sugar can affect the bacteria in your mouth which can lead to infections and plaque buildup. These issues can lead to gum disease, cavities, and even tooth loss. Symptoms can include pain, gum bleeding, and swollen gums. You should brush your teeth twice a day, and use floss and mouthwash as directed by your doctor.
You need healthy feet to get you to your appointments. Your feet should be checked daily at home and at every visit with your doctor. It can be helpful for your doctor if you remind them to check your feet by removing your shoes and socks at the beginning of the appointment. At home, you should check your feet every day for changes in color, cracks, cuts, sores, growths, and dry skin. If you have difficulty checking your feet, you may need to ask someone to assist you. You can also use a long-handled mirror or lay a mirror on the floor below your feet. High blood sugar can lead to diabetic neuropathy, infections, slow healing wounds, and in severe situations, amputation. If you have diabetic neuropathy, or to prevent sores, you can go to a specialist store that does shoe fittings and recommendations. Good foot care also means washing your feet each day, drying them well, and using moisturizer. You want to avoid using moisturizer between your toes, as this can provide an environment for bacteria and fungus to grow. Some people living with diabetes can even benefit from a regular nail trimming by a podiatrist to prevent cutting the skin when clipping and ingrown toenails. Medicare, Medicaid, and private insurances often help pay for this service.
All of this may seem overwhelming, but you can stay organized and on top of your testing by writing down what you have had done and what you need in the future. It also helps that a few of the tests you need can be completed at the same time during a regular blood test; A1C, kidney function, and blood lipids. Your doctor will most likely request this testing prior to an appointment where they will check your feet and blood pressure. Modern health systems now have reminders about vaccinations which make it easier for the doctor and patient to remember when vaccinations are due. The more you stay on top of your testing and managing your diabetes, the less likely you are to develop complications. You can live well with diabetes.
Faye Kinard is a Community Health Nurse at York County Area Agency On Aging. She is also a leader for York County Area Agency On Aging’s diabetes self-management program, Living Well With Diabetes. She is a member of the Diabetes Coalition of York County.
