The Joslin Diabetes Center in Boston Massachusetts is one of the best and oldest teaching facilities for diabetes education in the United States.
In their booklet ON THE ROAD TO LIVING WELL WITH DIABETES there are 5 tests recommended that all Diabetics should have done on a regular basis. Not being in range on the results of these tests doesn’t make the individual a bad diabetic but instead should be seen as being like a smoke alarm – they can detect danger and warn you that you need to take action.
Acting on the results can lower your risks for complications.
The five tests are: 1. The A1C test
2. Blood Pressure Check
3. Microalbumin test
4. LDL Cholesterol test
5. Eye exam
THE A1C TEST
This is the most important test for a diabetic. Also called the Glycated Hemoglobin test – it is a non fasting blood test that gives a picture of your average blood sugar over a 3-4 month period.
Checking your blood sugar at home shows your blood sugar at the time it is taken- like a snapshot. The A1C gives the long term picture of how well your diabetes care is working.
A Target number for the A1C test is 7 or less. If it is higher than 7 then your blood sugar levels are too high and action is needed!
Action to lower the A1C would include being more active- following a meal plan- checking your blood sugar daily and adjustment if diabetic medications.
The A1C should be checked every 3 months if it is not within range and twice yearly if the target is being met.
Lowering the A1C number will help prevent eye, kidney, and nerve problems. Every one point drop reduces your risk by half.
The A1C is now being used to diagnose Diabetes. Two separate A1C tests with a result of 6.5 or greater can indicate that the person is diabetic.
THE BLOOD PRESSURE CHECK
Many diabetics have hypertension or high blood pressure as well as other cardiac complications.
Diabetics are twice as likely to have a heart attack or stroke as non-Diabetics so it is important to check your blood pressure regularly before complications occur.
Blood pressure officially be checked once a year but it is a good idea to have it checked regularly.
The target number for blood pressure according to Joslin is 130/80. However in January of this year the American Diabetes Association changed the recommendation to 140/80.
Action that be taken to lower blood pressure include becoming more active- losing weight- stopping smoking and started blood pressure medications.
THE MICROALBUMIN TEST
This is also one of the most important tests for Diabetics as it shows how well your kidneys are working. This is a urine test that can be done at your Doctor’s office or a clinic.
This test measures the amount of protein or albumin in the urine. Protein should not be detected in the urine. It’s presence is the first warning sign of kidney disease. If caught in the early stages it is very treatable .
The target number for the Microalbumin test is 30 or lower. The test should be done at least once a year. It is very important to know your number. Action needs to be taken promptly if your number is higher than 30- without treatment your kidneys can be damaged.
Actions to lower or slow kidney problems would include keeping the A1C and blood sugars levels in target level, keeping blood pressure under control, and talking to your Doctor about medicines called Ace Inhibitors which can protect the kidneys and keep your microalbumin from rising.
THE LDL CHOLESTEROL TEST
This test measures the amount of fat in your blood. Cholesterol is made in the liver and can come from food.
The two main types of cholesterol are the HDL ( the “good” kind that protects against heart disease) and the LDL ( the “bad” kind that can damage your heart)
The LDL in your blood sticks to the walls of the arteries, clogging them and preventing blood from flowing freely. This can lead to heart attacks, strokes or other circulatory problems. But treatment can lower the LDL.
The LDL test should be checked at least yearly.
The target for the LDL test is 100 or lower, A number higher than 100 means that you and your Doctor need to take action,
Action to lower the LDL includes increasing you activity level, keeping your blood pressure at or near target range, stop smoking, losing weight, eating less saturated fat ( meat and dairy products) and discussing with your physician the need for a statin medication to lower the LDL cholesterol.
THE EYE EXAM
Having diabetes can put a diabetic at high risk for serious eye problems. Diabetics can have cataracts , glaucoma or diabetic retinopathy involving the tiny fragile blood vessels of the eye.
Any one of these can result in vision loss or blindness.
Some Diabetic eye disease show no signs or symptoms until there is a problem. However early discovery and treatment can prevent or stop most of these problems.
The eye exam should be done at least once a year and the eye should be dilated- with drops to enlarge the vessels so they can be examined.
Action to lower the risk of diabetic eye disease would include keeping your A1C and blood sugar levels in the target range, stop smoking and having the yearly eye exam.
Other exams that are of benefit to diabetics would include a dental exam every 6 to 12 months and a foot exam by a Health Care professional at least yearly,
Prevention is an important part of diabetic management.
DID YOU KNOW?
The Hampshire County Diabetes Support Group meets monthly on the 4th Wednesday at 1 pm at the Romney Senior Center.
There are still scholarships available for the Diabetic Exercise program at the Wellness Center. The scholarships are sponsored by the Hampshire County Diabetes Coalition. A MD referral is required for the program. To apply for the scholarship contact the Wellness Center at 304-822-7255.
Applications are available for the 6th Annual Walk For Diabetes Awareness. The walk is May 17th OR CAN BE DONE ON YOUR OWN after registering. The cost is $10 and each participant will receive a t-shirt. Call Pam Francis at 304-813-6588 for more information.