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Diabetes Knowledge

8 regular and important lab checks for people with type 2 diabetes

2/3/2020 by Michèle Theißen

8 regular and important lab checks for people with type 2 diabetes

Do you know your health numbers? Diabetes isn’t only about blood sugar! It is recommended that people with diabetes have regular check ups and labs completed. It can be challenging to keep it all straight, so we explain each important test below.

And what's all the fuss about? So that you feel as fit and healthy in the next few years as you do today. And if something comes up in an exam, you can take action immediately. 

We are not machines. There are no spare parts stored for us, so we must take special care of our bodies. So make appointments, get a check-up and your monster and you can sleep peacefully. 

Some regular check ups, such as measuring your blood sugar or weight, you can do yourself, others require you to see a doctor: 

1. HbA1c check - average blood sugar over time

The HbA1c is our average blood sugar over the past 8-12 weeks. The "HB" in HbA1c stands for hemoglobin, which is in our red blood cells and attracts sugar molecules in the blood. The HbA1c measures how many of these sugar molecules are stuck to the hemoglobin. A1c is the average over the past 8-12 weeks because that is how long the average blood cells lives in our body.  It’s measured in the lab, at your doctors office, or you can even buy a kit from the pharmacy to measure at home. It’s expressed as a percentage value (e.x. 7%). 

Remember, A1c is an average measurement. It cannot tell us whether our glucose was steady at this level overall, or if there we had a lot of hyperglycemia and hypoglycemia. The higher our blood sugar levels are and the longer they remain elevated, the higher the HbA1c is.Studies show that keeping your A1c close to target can help prevent the development of complications associated with diabetes. 

Target: 7% of less for most people with diabetes, but should be individualized

Frequency: every 3 months

Tip: If you measure your blood sugar level at least 3 times a day for 7 days in a row, we will calculate an estimated HbA1c value directly in the mySugr App. This is an estimate, so it may differ a little bit from your HbA1c determined in the lab, but will at least give you an idea of how your monster is doing right now.  

HbA1c table

2. blood pressure check

Diabetes, especially Type 2 diabetes, are unfortunately comrades and are often seen together. So check your blood pressure (you can also log your blood pressure in the mySugr app) regularly. High blood pressure is commonly referred to as the “silent” killer because there are no symptoms. And high blood pressure over long periods of time causes damage to our small and large blood vessels. 

So remember: besides sugar, blood pressure is also a very important value that you should know!

Target range: below 130/80 mmHg

Frequency: at least every 3 months in the doctor's office 

Tip: If you already know that you have high blood pressure, you can also ask your doctor for a prescription for a blood pressure monitor and measure it more often at home to keep an eye it.

 

3. blood lipids check 

Once a year the blood lipid values, cholesterol (LDL and HDL) and triglycerides, should also be determined in the blood. These are also often out of balance in Type 2 diabetes. Remember by “L”, because we want to be Lower and “H” we want to be Higher.” Think of HDL as a street sweeper, which cleans up LDL, taking it to the liver to be broken down. 

Too much LDL or not enough of HDL increases the risk clogging up big blood vessels that feed the heart and brain. Triglycerides are a different type of fat found in the blood. We need them, just not too much. Too much triglyceride is associated with total body inflammation and can damage the liver, pancreas and arteries. 

Target range:              

  • HDL (?): Women above 50 mg/dl / Men above 40 mg/dl
  • LDL (?): below 100 mg/dl , below 70 mg/dl for increased risk of  cardiovascular disease
  • triglycerides (fat in the blood): less than 150 mg/dl 

Frequency: 1x per year

4. eye check

Eye complications usually develop gradually. At first there may be no noticeable symptoms or visual impairment, but if blood sugar levels are elevated for long periods of time, it can damage the eyes. Elevated blood sugar affects the tiny blood vessels of the retina, so there is a risk of damage to the back of the eye, also known as diabetic retinopathy. 

Frequency:

  • In eyes with no retinopathy: 1-2x/year
  • In existing retinopathy: every 3-12 months, depending on condition

 

Tip: Double check your insurance to make sure you have eye doctor coverage!

5. kidney check

Our kidneys are a sophisticated filtration system, which has a lot of small blood vessels. The kidneys can suffer damage from elevated blood sugars overtime. Because of this, microalbumin in urine is examined. Microalbumin are very small protein particles that slip through the kidneys when the filtration system is damaged, so it is an early warning sign of kidney damage. In addition, the creatinine value and the glomerular filtration rate (GFR) can are checked in a blood test, which also can give insight to how well the kidneys are functioning. 

Target range:

  • urinary albumin excretion: below 30 mg/g
  • Creatinine in blood: Women: below 0.9 mg/dl / Men: below 1.1 mg/dl
  • GFR : over 90 ml/min x 1.73 m² 

 

Frequency: at least 1x per year, every 3 months if kidney damage is present. 

6. foot check

There are many blood vessels and nerves in the feet. Loss of sensation or a weak pulse in your feet can be a sign of nerve and blood vessel damage from elevated blood sugars, so it’s important to check your feet regularly. Your doctor should check your pulse and the sensitivity of the nerves by using a tuning fork that causes a vibration and a fine nylon thread that is pushed against your toes. Don't worry, this is absolutely painless, but it could tickle! Learn more about diabetes and foot health in this article.

Frequency: at least 1x per year

Tip: check your feet at home every so often to catch any sores or cuts before your doctor's visit.

 

7. injection site check (for insulin therapy)

If you use the same needle and injection sites for too long, this can lead to scar tissue and thick tissue deposits to harden in the area. If you continue to inject in these areas, the insulin absorption is not as predictable and can cause crazy swings in blood sugar because accumulation of hardened or fatty tissue at frequently used injection sites interferes with the absorption of insulin into the body. You can do this examination yourself, but your diabetes team should also regularly check your injection sites. 

Frequency: at least 2 x per year 

Tip: to prevent this, rotate your injection and insulin pump sites often!
 

8. dental check

Yes, there is a connection here too. People with diabetes have a 3 times higher risk of gingivitis (severe gum inflammation) compared to people with out diabetes. The higher the sugar levels, the more likely we are to have gum inflammation and, in some cases, tooth loss. The inflammation of the gums and the bacteria that enter the bloodstream increase raise glucose as well and increase insulin requirements. To prevent gingivitis or manage, it’s important to brush your teeth and floss daily and never skip your dental check ups! Learn more about diabetes and dental health in this blog article. 

Frequency: 2x annual check-ups, more often in case of abnormalities

 

 

This article was updated in February 2020

Michèle Theißen

Michèle Theißen is our Head of Diabetes Coaching and has been a dedicated mySugr monster tamer since 2017. She is a certified dietician and certified diabetes educator DDG (German Diabetes Association).

For her, learning is a never-ending process. Which is why she is currently studying Health Care Management at WU Executive Academy in Vienna on a part-time basis.

Michèle found her specialization early on in diabetology.  She has supported people with diabetes in all forms of therapy for many years already. Before diving into building up the online coaching department at mySugr, she gained editorial experience working for Burda Publishing House.

You can listen to her talk about the mySugr coaching project in an episode of the German Zuckerjunkies podcast.

When Michele isn’t helping tame the diabetes monster, you’ll find her recharging in the outdoors or cooking.

 

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