Managing diabetes

Managing diabetes

In the long-term, diabetes is monitored through routine check-ups by your doctor and/or annual check-ups at the hospital on an outpatient basis.

Their purpose is to determine if treatment is satisfactory and to look out for any evidence of longer-term complications such as eye or kidney disease.

Tests for these complications are usually done at the annual check-up, while routine check-ups may be carried out every three to six months.

Routine check-ups

• Blood sample to check the amount of HbA1c (long-term glucose) in the blood.
• Evaluation of home glucose readings.
• Discussion of diet.
• Blood pressure.
• Weight check.
• Other tests and examinations as determined by your doctor.

Annual check-ups

• Blood sample to check the amount of HbA1c (long-term glucose) in the blood.
• Blood sample to determine the amount of fats in the blood.
• Blood sample to check kidney function and various salts in the blood (mainly sodium and potassium).
• Blood pressure.
• Urine sample to determine the presence of protein (albuminuria). The appearance of protein can indicate that the filtering power of the kidneys is beginning to be affected by the diabetes.
• Foot examination, including a check of various pulse points on the foot.
• Weight check.
• Measuring the waistline.
• Discussion of exercise habits.
• Discussion of smoking habits.

Long-term prospects

Both types of diabetes have the risk of complications.

Acute complications

• Low glucose level, caused by treatment with insulin or oral hypoglycaemic drugs.
• Diabetic acidosis, a life-threatening condition caused by the lack of insulin.

Late-stage diabetic complications

• Retinopathy (eye disease) that can cause blindness.
• Diabetic kidney disease that can lead to kidney failure.
• Diabetic neuropathy (nerve disease) that can cause foot ulcers and foot infections.
• Atherosclerosis (hardening of the arteries), particularly in smokers and those with high blood pressure.

Late-stage complications do not usually develop for 10-15 years with Type 1 diabetes.

In Type 2 diabetes, however, symptoms can appear close to the time of actual diagnosis because the disease may go undetected for longer.

Many studies now show that good glucose control can significantly reduce or even stop complications. This means keeping the blood sugar level as close to normal as possible.
Recent studies have also confirmed the need for people with diabetes to reduce their risk of atherosclerosis (fatty deposits in your arteries).

This is because if you have Type 2 diabetes, you have a four to five times greater risk of developing serious problems with your circulation that can lead to a heart attack or a stroke.

The main factors that increase your risk are:

• smoking
• high blood pressure
• raised levels of fats such as cholesterol in the blood.

By taking measures to address these issues, you will reduce your chance of developing complications such as heart disease.

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