Comprehensive checklist for managing diabetes

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While changes with respect to food and lifestyle are essential to control diabetes, knowledge on the various tests to be taken and awareness of what the numbers mean also contribute towards the same.

Here is a complete checklist on important diabetes tests (including when to take these tests and why) and target numbers.

WHAT WHY RECOMMENDED OUTCOME
Hemoglobin A1c Test: Every 3 months A1c is a blood test that measures how well your blood sugar is controlled over the past 2-3 months. It helps you and your doctor know how well your treatment plan is working. Less than 7, or what your doctor says is right for you. Generally lower is better.
Blood Pressure: Every visit High blood pressure increase your risk of diabetes complications. Less than 120/80, or what your doctor says is right for you. Generally lower is better.
Cholesterol Test: At least 6 months Elevated LDL (or “bad”) cholesterol increases the risk of heart and circulation problems in patients with diabetes. Less than 100 if possible. “Statin” medicines may be very helpful.
Kidney Management: Annually Diabetes is the most common cause of kidney failure.  Urine tests help doctor know whether the medications should be used to delay kidney problems. Urine “microalbumin” should be less than 30; if it is higher, “ACE inhibitors” or “ARB” medicines will help you.
Eye Examination: Annually Diabetes is the most common cause of blindness in adults. Early Detection and treatment of eye problems can reduce your risk. Normal annual eye examination by an eye doctor, or treatment if eye problem are discovered.
Foot Examination: Annually Diabetes is the leading cause of foot and leg amputations in adults. Nerve damage may reduce your ability to detect foot pain from an ulcer or infection. Healthy feet, or early detection of treatable ulcers or infections. Advanced diabetic foot evaluation is advised yearly.
Weight: Every visit Obesity worsens blood sugar control; exercise and weight loss improve blood sugar control. Body Mass Index (BMI) less than 23. Plan to exercise and lose weight!
Smoking Status Smoking increases an already high risk for heart disease and circulation problem in patients with diabetes. STOP SMOKING!
Pneumonia Vaccine: Once in 5 years If your diabetes is not well controlled, you are at higher risk for infections. A vaccine against pneumonia can reduce your risk. Recommended for all diabetics above 50.
Flu Vaccine(Influenza): Annually Influenza is a serious disease that leads to hospitalization and sometimes even death. Vaccinations can prevent this. Recommended for all diabetics above 50.
Extended Lipid Profile: Annually It is used to identify risk factor for premature heart disease in high risk individual. It helps in knowing heredity risk factors related to heart diseases. Can help identify people at high risk for heart disease.
Thyroid Panel (T3, T4, TSH): Annually To help prevent thyroid gland functions and help diagnose thyroid disorders. T3- 60.00 – 181.00 ng/dLT4 – 4.50 – 12.60 µg/dLTSH – 0.3 – 3 mIU/mLIf the results are high or low, it can be treated with medications.
Medical Nutrition Therapy and Lifestyle Intervention Medication and Exercise along with Medical Nutrition holds the key for managing Diabetes. Prevent or slow down the rate of development of chronic complications like cardiovascular disease, hyperglycemia etc.

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Dr. Rajiv Kovil
Consultant Diabetologist, Dr. Kovil’s Diabetes Care Centre

Dr. Rajiv Kovil is a Consultant Diabetologist at Dr. Kovil’s Diabetes Care Centre, the first Preventive Diabetes Centre & Diabetic Foot Clinic in Mumbai, KLS Memorial Hospital and Holy Spirit Hospital among others. He is a founder member of United Diabetes Forum, a forum of practising diabetologists in India. He has also written various articles on diabetes for medical journals such as Asian Journal of Diabetology and Medical Image. His Preventive Diabetes Centre & Diabetic Foot Clinic is an initiative to provide preventive diabetic measures as well as to function as a specialized Foot Clinic for diabetic patients not only in terms of equipment but more importantly in terms of expertise.

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