Related topics: •  Clinical Guidelines for Your Diabetes Care (Summary) •  Diabetes Center •  Diabetes and Herbs Alert

Feel free to print out this checklist and take it with you when you see your doctor. It's a summary of recommendations that the American Diabetes Association has made to physicians regarding their patients with diabetes. The organization calls for:

•A referral to a diabetes educator on your first visit. He or she can help you set up a program to manage your diabetes and avoid complications; an annual follow-up will help you gauge your progress.

•Quarterly checkups if you take insulin, have trouble controlling your glucose levels, or even if your blood sugar is under control. The ADA recommends four visits a year to evaluate your lifestyle changes and check on your progress with the disease. This means you should see your physician at least every three months.

•A foot inspection every time you visit your physician, so he or she can check your feet for nerve damage, foot ulcers, and sores. (You should have a foot and leg inspection quarterly. To help remind yourself, take off your shoes and socks each time you visit your physician.) The ADA also recommends an annual comprehensive exam of the feet which includes nerve testing.

•Every three months, a hemoglobin A1-C blood test to monitor long-term glucose control for patients not meeting blood sugar goals. For patients meeting treatment goals, an A1-C blood test should be performed at least two times a year.

•Once a year, a urine test to check for small amounts of protein -- an early sign of kidney damage.

•Once a year, an eye exam to inspect for cataracts or deterioration of the retina.

•Once a year, a cardiovascular exam, including your cholesterol and triglyceride profile.

•Once a year, a vaccine for influenza.

On each visit, your doctor should check on:

•your weight

•medications

•your blood pressure

•your blood glucose self-monitoring

•tobacco or alcohol use

•lifestyle issues

•diabetes complications such as eye or kidney problems

•psychological or social issues such as depression

•previous abnormalities on your physical exam

•episodes of high or low blood sugar - how often they've occurred, their severity, and your plan on dealing with them.

If you smoke, the ADA recommends that you talk with your health care provider about ways to quit. You can work together to find the best method for you, whether it's cold turkey or a more gradual approach.

•If your clinic doesn't mention it, ask what lab work you need done before the visit. Your doctor may want you to get tests for Hemoglobin A1-C, BUN/Creatinine, urine albumin/creatinine, lipids (which require fasting for 14 hours), or others. That way, the test results will be available at the time of your visit.

•Think about what you want to cover in the visit. Print out the above checklist and bring it as a reminder, if necessary.

•Make a list of the medications and supplements you take and bring it with you. If this is difficult, put all the medicines, herbs, and supplements you're taking in a brown paper bag, and take that to the clinic to show the doctor.

-- Sarah Henry is an award-winning health writer specializing in parenting and social issues. She was a staff writer for the Center for Investigative Reporting for more than a decade, and has also reported on health issues for Hippocrates, Time Inc. Health, the Washington Post, the Los Angeles Times Magazine, and for television programs such as "60 Minutes" and PBS's "Health Quarterly."

Further Resources

American Diabetes Association

800/342-2382

http://www.diabetes.org Joslin Diabetes Center

617/732-2400

http://www.joslin.org The Unofficial Guide to Living with Diabetes, Maria Thomas, Loren Green, M.D. Macmillan Publishers

References

First published January 22, 2001
Last updated August 27, 2008
Copyright © 2001 Consumer Health Interactive

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