10 things to discuss at your next diabetes checkup
January 6, 2017 | 0 comments
| Author: doctorchrisp
Christopher R. Palmeiro, D.O., M.Sc.
Diabetes can be overwhelming. Between checking your blood sugar, taking medications at the appropriate time, injecting insulin if it is prescribed, watching your diet and following up with several different types of doctors, it can be hard to keep track of everything you need to do.
If you have diabetes, doctors will keep a closer eye on certain parts of your health. For example, eye checkups and foot checks should occur at least once a year.
Here is a list of the top ten things you should discuss with your doctor at your next diabetes checkup (hint – they are all important).
- Your fingerstick blood sugars – Things to discuss would be how often the doctor expects you to monitor your sugar, how your blood sugar levels have been running, and whether your prescription for testing supplies is up to date. To help out, you should consider bringing your blood sugar log to the visit, as well as your glucose testing machine (glucometer). In case the doctor needs to refill testing supplies, knowing the machine and testing strip name is important.
- Hypoglycemia – Some might argue this falls under number 1 above, but it is so important that it got its own category. One of the most important things you can discuss with your doctor is whether your sugar is getting too low at home, a condition health care professionals call hypoglycemia. Hypoglycemia has been tied to many serious problems, including heart electrical problems called arrhythmias. These can be very dangerous and lead to death.
- Your A1c – The Hemoglobin A1c is a blood test that tells the doctor what your average blood sugar has been over the past two to three months. The ideal A1c goal number is often under 7%, but this varies with the individual. It is good to know your A1c and what the doctor considers your goal number.
- Your last cholesterol test – Doctors have tighter cholesterol goals for those affected by diabetes. The bad cholesterol (LDL) goal is often lower than what can be achieved by diet alone. For this reason, most patients with diabetes are offered a cholesterol pill called a “statin.” You should have your cholesterol drawn and tested at least once per year.
- Your last urine test for microalbumin – Microalbumin is a tiny amount of protein that can be found by checking the urine — it is a marker for microscopic kidney damage. You cannot feel this damage, and so this test is important. This test is done in addition to blood testing, so make sure you have a urine sample test at least once a year.
- Your diabetes medications – This is a big topic, but generally speaking, doctors now have more classes of medications to choose from. The newer guidelines suggest using medications that assist with weight loss, while not causing hypoglycemia.
- Your last influenza and pneumococcal vaccines – Patients with diabetes have different vaccine recommendations than the general population. This is due to the increased risk of hospitalization for the flu and pneumonia seen in those with diabetes.
- Your last dilated eye exam – A full eye exam is recommended at least yearly to screen for what doctors call retinopathy. Retinopathy is damage to the small blood vessels in the back of the eye, which are very sensitive to high blood sugar.
- Your last comprehensive foot check – This is recommended at least once a year, and should include testing for nerve damage by touching the bottom of the foot with a light filament.
- Your last diabetes education class – Ongoing diabetes education is extremely important to help manage diabetes. In fact, Medicare will pay for thorough education at diagnosis, as well as two additional hours of education each year.