Diabetic Guidelines
Good Health Guidelines for People with Diabetics

1. HbA1C*
   This blood test measures blood sugar control over the past 90 days. The closer your A1C is to that of people who do not have diabetes, the less chance you have of damage occurring to your heart, eyes, kidneys and blood vessels. A1C should be tested two to four times a year, depending on how well your blood sugars are managed and/or if you have had a recent change in your diabetes medications. The goal of A1C levels is < 7.0%. (Note: Many physicians and diabetic experts are trying to have this A1C number in the low 6’s).



2. Blood Pressure*
   High blood pressure (hypertension) can lead to a heart attack, worsening heart failure, stroke or kidney failure. Both the American Heart Association and the American Diabetes Association recommend blood pressures of less than 130/80 for people with diabetes. Make sure that you have your blood pressure checked at every visit to your health care provider and talk with your doctor about how to reach your blood pressure goals.



3. Foot Inspection / Examination*
   You should inspect your feet every day for signs of redness, warmth, swelling, or calluses, which can be early warning signs of conditions that can lead to serious foot problems. In additions, people with diabetes should have their feet inspected by their health care provider during each visit. You should also have a complete sensory foot exam done by your doctor every year.



4. Dilated Retinal (Eye) Examination*
   People who have diabetes should have a dilated retinal (eye) examination every year. Early detection and treatment of changes in your eyes can often prevent blindness. Remember this is a special eye exam and is different than having your vision checked for glasses.



5. Dental / Periodontal (Gum) Examination**
   People with diabetes (especially with poor blood sugar control) are more likely to have gum disease than people without diabetes or who have good control. Additionally gum disease may make it more difficult for people with diabetes to control their blood sugar levels. Gum disease is a chronic oral infection due to the presence of bacteria in the mouth. Generally, diabetics have more problems with wound healing and dealing with infections. If you are diabetic, you should have regular (two to four) dental cleaning visits each year as recommended by their dentist, practice exquisite oral hygiene measures at home every day, and be more pro-active rather than “wait-and watch.”



6. Fasting Lipid Profile*
   High levels of lipids (fats) in the blood can lead to a heart attack and stroke. People with diabetes are at a higher risk for heart attacks and strokes than those without diabetes. Lipid profile tests should be done at least once a year so that you and your doctor can develop a plan to reduce your risk for a heart attack.
   
   
7. Urinary Protein / Microalbumin*
   Measuring your urinary protein will give you and your doctor information about the health of your kidneys and blood vessels. You should have an annual test for urine protein/albumin if you have type 2 diabetes or if you have had type 1 diabetes for more than five years.

*American Diabetes Association: Standards of Medical Care for Patients with Diabetes, Diabetes Care 28 (Suppl. 1); 2005. http://care.diabetesjournals.org/cgi/content/full/28/suppl_1/s4

**American Association of Periodontology,Gum disease and Diabetes, The Mouth-Body Connection;
http://www.perio.org/consumer/mbc.diabetes.htm
http://www.joponline.org/doi/abs/10.1902/jop.1999.70.11.1313