Thursday, June 7, 2012

What tests should my doctor be doing on a regular basis to monitor my diabetes?

Some of the tests that  your doctor will perform to monitor  your diabetes and  the  status of any of its chronic  complicationThe main things that interest your doctor are monitoring the control of your blood  sugar, the control of your cholesterol and blood pressure, and  the presence or progress of any long-term complications of your diabetes  and  to check for the presence or absence of other related con- ditions.  Tests  in  this  context  can  refer  to  clinical examination, such as checking the condition of your feet and testing the sensation, laboratory blood tests, and special tests, as indicated, such as scans or other images. Many of these your doctor can  do himself 

Table 10   Items That May Be Checked Regularly in Persons  with Diabetes         Monitoring Tool

Glucose control                    HbA1c, fructosamine, CBGs, eAG Lipids            Fasting lipid panel ± special lipid tests
Blood pressure                     BP cuff measurements
Large vessel health                 EKG, carotid IMT
Small vessel health
Feet                                       Inspection, microfilament, capillary refill, ABIs
Kidneys                               Serum creatinine, estimated CCr, MACR Eyes    Retinal imaging, dilated eye exam Peripheral nerves                                  Monofilament, NCV testing, touch and
vibration perception, proprioception*
Autonomic nerves               Postural BP, pulse, RR variation

Abbreviations: HbA1c: hemoglobin A1c; CBGs: capillary (fingerstick) blood glucoses; eAG: estimated average glucose; BP: blood pressure; EKG (ECG): electrocardiogram; IMT: intimal-medial thickness by ultrasound; ABIs: ankle- brachial indices; CCr: creatinine clearance; MACR: microalbumen-to-creati- nine ratio; NCV: nerve conduction velocity; RR: R-wave to R-wave (on EKG).
*Position sense.

and others may require referral to another specialist. A
detailed eye examination is an example of the latter.

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