Your guide to diabetes checkups
When you have type 2 diabetes, you’ll get a series of physical exams and lab tests each year for your diabetes and to screen for any complications. Here’s a schedule of what to expect from your appointments and a list of what to bring to the doctor’s office with you. Being prepared can help you make the most of these appointments and possibly prevent or delay diabetes complications.
Physical exams and appointments
- Weight and height measurements for calculating BMI (every visit)
- Blood pressure measurement (every visit)
- Foot check with diabetes care provider (every visit) or podiatrist (once a year or more often if you have problems)
- Setting goals for food and exercise with diabetes care provider, nurse, physician assistant, or certified diabetes educator (once a year or more often)
- Discussion of medications, old and new, as well as refills of prescriptions (every visit)
- Comprehensive dilated eye exam by optometrist or ophthalmologist (once a year; every other year if your eye specialist recommends it)
- Teeth cleaning (every 6 months) and mouth exam (once a year) by dental hygienist and dentist
- Ankle-brachial index test if you have signs of peripheral artery disease, or PAD (as needed)
Lab tests
- A1C test, by diabetes care provider (blood test; 2 to 4 times a year)
- Cholesterol measurements for LDL and HDL cholesterol and triglycerides (fasting blood test; every 5 years or more often as needed)
- Serum Creatinine/eGFR (blood test; once a year) to measure your kidney function
- Urine albumin-to-creatinine ratio (urine sample; once a year) to measure your kidney function
What to bring with you
- Blood glucose meter or logbook
- A list of all your current medications
- A list of questions or concerns to discuss with your provider
- Anything else your healthcare provider’s office specifies
Don’t be afraid to call and ask what you need to bring.
How to check your blood glucose
Checking your blood glucose when you have type 2 diabetes requires pricking your finger and using a blood glucose meter to get a reading. Many people are intimidated by the idea of using a blood glucose meter, especially when they’re first diagnosed. But it takes only seconds once you get the hang of it.
Follow these six simple steps to check your blood glucose:
- Wash and dry your hands.
- Insert a test strip into your meter.
- Use a lancing device to prick the side of your finger and draw a small sample of blood.
- Hold your finger to the test strip.
- Wait for the reading.
- When the reading displays, record it or use it to take appropriate action.
Treating low blood glucose
A blood glucose reading below 70 mg/dL is called hypoglycemia (low blood glucose). Low blood glucose can be dangerous when you have type 2 diabetes, so it’s important to recognize the symptoms of low blood glucose and understand how to treat it.
Warning signs of lows
The symptoms of low blood glucose can be different for each person, but classic warning signs of lows include
- Shaking
- Nervousness or anxiety
- Sweating, chills, or clamminess
- Irritability (or, with severe lows, anger, sadness, or stubbornness)
- Color draining from the skin
- Hunger and nausea
- Rapid heartbeat
- Weakness, fatigue, or sleepiness
- Headache
- Tingling or numbness in the lips or tongue
- Nightmares or crying out during sleep
- Lightheadedness, dizziness, or confusion
- Difficulty seeing or blurry vision
- Unusual behavior such as clumsiness or slurring of words
- Anger, sadness, and/or stubbornness
- Seizures or becoming unconscious with severe lows
Rule of 15
The “Rule of 15” is an easy method for treating low blood glucose. The method is called the Rule of 15 because you treat lows with approximately 15 grams of fast-acting carbohydrate (such as glucose tablets or gels, fruit juice, or regular soda) and then retest your blood glucose after 15 minutes. Before using this method, ask your doctor to make sure it’s right for you. To put the Rule of 15 to use, follow these steps:
- Test your blood glucose.
- If your blood glucose is below 70 mg/dL, eat or drink something with 15–20 grams of carbohydrate.
- Wait 15 minutes.
- Test again and if your blood glucose is still below 70 mg/dL, eat or drink another 15 grams of carbohydrate.
- Repeat until normal.
Consider eating a snack after an episode of low blood glucose if your planned meal is an hour or more away.
Reading food labels for carbohydrates
Food labels are a fabulous resource for finding out how many carbohydrates are in your foods. You can use these labels to compare the carbohydrate content of different products and track the amount of carbohydrate you eat. Reading food labels is a vital skill for anyone who counts carbohydrates. To find the amount of carbohydrates in your foods, follow these steps:
- Look for the line that reads “Total Carbohydrate” on the label.The value on this line will tell you how many grams of carbohydrates are in one serving of the food.
- Check the number of servings per container to see if your package has one or more servings.
- Check the serving size of the food to determine how many servings you plan to eat.
- Multiply the number of servings you plan to eating by the grams of carbohydrate in the “Total Carbohydrate” line to determine how many grams of carbohydrate you will be eating.
Some people with diabetes who are counting carbohydrates can subtract the grams of Dietary Fiber — listed under Total Carbohydrate on the food label — from the grams of Total Carbohydrate because dietary fiber has a minimal impact on blood glucose. Ask your dietitian or diabetes care provider if subtracting the fiber from the total carbohydrate grams is necessary or appropriate for you.
