It is essential that your diabetes is reviewed yearly by your diabetes team. This so that we can catch any potential problems early on hence It is very important that you attend regular appointments where you will have:
Blood Tests: for your blood fats and HbA1c (which your long term diabetes check) and your kidneys
Blood Pressure Checks
Weight Measurement
Foot Check with the podiatrist including pulses and sensation
Eye check (with your optician or optometrist)
Urine test. (You will be asked to bring a sample with you.)
HbA1c or A1 BLOOD TEST
The diabetes team will take a blood sample from your arm. During the life of a red blood cell (8-12 weeks) sugar sticks to part of it. This blood test gives an overview of the level of your blood sugars over the last 2-3 months. This will inform your diabetes team as to the level of your diabetes control.
HbA1c Target Level To show good diabetes control the HbA1c result should be between 6.5-7.5% where 7% is the ideal target.
Ways to reduce your HbA1c Always ask your diabetes team what your HbA1c result was, and by comparing it with previous results you will be able to monitor your progress. If your HbA1c is too high, your current diabetes treatment may need changing.
You can download the new Haemoglobin A1c Testing (HbA1c) information leaflet produced by the Department of Diabetes and Endocrinology and the Department of Ophthalmology Department 2008 Scroll to the bottom of the page.
BLOOD FATS (LIPIDS)/ CHOLESTEROL TEST
Cholesterol is fat that circulates around the body in your blood. There two main types of blood fats these are:
Low Density Lipoproteins (LDL’s) “ bad Cholesterol” these are sticky and tend to build up as fatty deposits around the inside of blood vessels hence obstruct blood flow
High Density Lipoproteins (HDLs) “ good cholesterol” these help prevent fatty deposits and keep blood vessels free from obstructions.
Cholesterol Target Level: to reduce you risk of getting a heart attack the total cholesterol level should be below 5mmol/l Recent research has shown that a level nearer 3.5mmol/l may be better.
Having too much fat (bad cholesterol) in the blood can contribute towards developing heart diseases and stroke.
Ways To Reduce Your Lipid Levels:
Reduce weight and saturated (animal) fat intake; take regular physical activity; eat more fruit and vegetables, eat oily fish twice a week, limit alcohol intake, control glucose levels.
BLOOD PRESSURE CHECK
Blood pressure is the amount of outward pressure that your blood puts on the walls of your blood vessels. Thus a blood pressure check is the measurement of the pressure at which your heart pumps blood through you arteries.
There are two numbers, a systolic and diastolic the systolic is the amount of pressure when your heart pumps the blood and is the higher value. The diastolic is the amount of pressure when your heart is recovering before it pumps again, this is the lower value.
Target blood pressure the target is 140/80 mmHg or below. If you have kidney problems then the target is 130/70mmHg
High blood pressure is an important contributor to conditions such as heart disease, stroke and kidney disease.
Ways to reduce your blood pressure : loose excess weight and keep it off, reduce salt intake and stress levels, stick to recommended alcohol intake, increase regular physical activity, stop smoking.
WEIGHT MEASUREMENT
Carrying too much weight around your middle increases your risk of heart disease, affect BP and cholesterol and can make you insulin resistant. Your diabetes team will weigh and measure your height and check your Body Mass Index (BMI) to find out your health risk.
They may also take a waist circumference measurement to predict your risk.
European men: 94cm or 37 inches at risk, 102cm or 40 inches High Risk Asian Men 90cm or 36 inches at risk European 80cm or 32inches at risk, 88cm or 35 inches high risk Asian women: 80cm or 32inches at risk, 88cm or 35 inches high risk
If you are overweight, a 5-10% weight loss can reduce the risk of heart disease and stroke. E.g. if you weight 100 kg aims to lose 10kg. On the other hand being underweight is not healthy and can be due to poor diabetes control. Discuss this with your diabetes nurse/team. If needed you can request to be referred to dietician. Ways to lose weight
EYES TESTS/PHOTGRAPHS
Regular annual eye examinations or screening are extremely important to detect both, eye problems associated with diabetes (diabetes eye disease) and unconnected conditions your eyesight. Make sure your eyes are checked at least once a year so any problems can be picked up and treated early. This can only be detected by a detailed examination of the eye including eye photography by your optometrist or eye clinic.
You may not realise that there is anything wrong with your eyes until it is too late. If you notice changes with your eyesight, you should contact your optician or eye clinic.
N.B. Eye examinations are free for people with diabetes and are exempt from most charges with in General Ophthalmic Services.
FEET EXAMINATIONS
Your feet will be examined by your doctor, nurse or podiatrist (foot specialist) They will check for pulses, cuts, bruises, marks and blisters. A sensory nerve examination can be carried out by your diabetes team.
The sooner changes or problems are spotted, the more likely it is that they can be treated and prevented from getting worse. In addition you should keep a close eye on yourself by checking your feet daily. If you notice anything unusual, such as unusual cuts, marks, discolouration or blisters on your feet, see your GP as soon as possible. If you think anything is wrong contact your clinic straight away.
KIDNEY FUNCTION TEST
The diabetes team will either check your urine to see if your kidneys are performing well, this will include protein presence.
ANNUAL CHECKUPS GENERAL RULES:
Have your blood pressure checked at least once a year.
Check your feet daily and visit a chiropodist (foot doctor) at least once a year.
Have your eyes checked at least once a year at your family optician with an optometrist. (Your eyes may be photographed)
Have your cholesterol measured at least once every three years
WHY IS IT IMPORTANT TO HAVE ALL THESE CHECKS?
It is necessary that you are examined and your diabetes is monitored professionally to prevent and detect any complications.
ATTEND REGULAR CLINICS
In between appointments it is also important to continue to monitor your diabetes yourself. If you think anything is wrong contact your clinic straight away.
It is a good way to set your personal targets for losing weight giving up smoking and to review the changes you have made to help you manage your diabetes better and see how well you are progressing. The sooner changes or problems are spotted, the more likely it is that they can be treated and prevented from getting worse.
NEW HbA1c Leaflet (PDF 1MB)