Diabetes Care


Diabetes Care

There are many treatment plans, or guidelines, out there; depending on which source you
review, you may find similar or completely different lists.  Remember that insurance plans
operate under different criteria than doctors do. Their goal is to operate a business while
a doctor's goal is to treat your health and medical problems.
 
     
Frequency of visits:
      Most physicians and diabetes experts suggest seeing your doctor every three months.
      During theses visits you may have lab ordered or done in-house; which should include
      a HBAIC, a accucheck (or review of your home BS checks and glucometer).
 
A foot exam for sensory testing and evaluation for calluses,
wounds and nail health should be included.
 
Blood pressure is monitored and should be kept <120/80.
 
EKG's: at least once a year for screening, as diabetics can develop
heart disease often without many symptoms.
 
 
Lab:
HBAIC: the goal in under 7, I prefer closer to 6.
AACE (American Association of Clinical Endocrinologists:  http://www.aace.com)
recommends  <6.5 (less than)
 
Lipids: generally, these are done about every 6 months depending on need or
change of medications.  Guidelines can be considered the following:
LDL between 80-100, depending on other medical history,
HDL > (means greater than) 40-50,
Total Cholesterol <(means less than) 200, and triglycerides <100.
 
Renal (kidney) function and liver functions every 3 months
(especially if you are on medications that affect or are effected),
unless there are problems that need more frequent monitoring.
 
Urine analysis: generally are checked at least twice a year to monitor
for protein and glucose.  If these are found, more specific tests such as a
microalbuminurua or 24 hour urine might be ordered.
 
Blood sugars:  recommended fasting <120 and postprandial <150.
 
 
Diet and Exercise:
This is very important and my patients know I nag them about these factors.
The saying "you are what you eat" really is meaningful in a diabetic.
Food can be poison to a diabetic.
Food and eating should not be a hobby for you!
 
 
 
Websites:
http://www.aace.com
http://www.diabetes.org/home.jsp
http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/index.html