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Diabetic Nephropathy (Kidney Disease)
If you have diabetes, urine testing should be performed yearly to look for diabetic nephropathy -- kidney disease. A baseline creatinineblood test should also be done to determine your kidney function. You may need to be tested more often if you're likely to get kidney disease because of high blood pressure, heart disease, or a family history of kidney failure.
Your doctor will check a sample of your urine for albumin, a blood protein that can end up in your pee if your kidneys are damaged.
They'll also take a sample of your blood to check your glomerular filtration rate (GFR), a measure of how well your kidneys are doing their job of filtering waste in your blood.
Your health care provider will also check your blood pressure regularly, because control of high blood pressure is essential in slowing kidney disease. Your reading should be less than 130/80.
Diabetic Neuropathy (Nerve Damage)
Over time, diabetes can cause nerve damage that produces symptoms of numbness, burning, or pain in your hands, feet, or legs. If your skin becomes numb, you may not notice small wounds that could grow to become bigger health threats. Check your feet and hands daily for redness, calluses, cracks, or skin breakdown. If you notice any of these symptoms before your next scheduled visit, notify your health care provider immediately.
To check for these problems, your doctor will thoroughly examine your feet at least once a year. They'll tap on them with a tool similar to a nylon hairbrush bristle or prick your feet with a small needle. If you don't feel it, you may have nerve damage.
If you're diagnosed with peripheral diabetic neuropathy, you'll need thorough foot exams at every doctor's visit.
Diabetic Retinopathy (Eye Damage)
To protect your vision, all people with diabetes should see an ophthalmologist (an eye doctor) at least yearly. As part of the eye exam, the doctor will dilate your eyes so that they can see the back of the eye (the retina) and determine if the diabetes is causing damage. For this test, your doctor puts drops into your eyes that temporarily make your pupils get bigger. Then, they use a special magnifying lens to check your retina and optic nerves. They'll also test your eye pressure, side vision, and distance vision.
The test is painless. But since you'll be sensitive to light and your vision will remain blurry for a few hours, it's a good idea to bring sunglasses and get someone else to drive you home.
In people with type 1 diabetes, these annual exams should start within three to five years of diabetes once the patient is age 10 or older. People with type 2 diabetes should have their first eye exam once they are diagnosed. Those with eye complications may need to see their ophthalmologist more frequently. Women with diabetes who become pregnant should have a comprehensive eye exam during the first trimester and close follow-up with an eye doctor during their pregnancy. (This recommendation does not apply to women who develop gestational diabetes.)
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