Diabetes Care Community

Category: Other monitoring

  • Recommended diabetes monitoring tests

    Recommended diabetes monitoring tests

    [vc_row][vc_column][vc_column_text]As someone living with diabetes, we invariably end up needing to schedule a host of diabetes monitoring tests. Although you may balk at so many appointments, it’s important to recognize that monitoring is a vital part of diabetes management, and is the key to delaying or preventing diabetes complications.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont1′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    Keeping track 

    Some monitoring tests you can do yourself, such as routine blood glucose monitoring, while the majority of them will be done at your doctor’s office or a lab. It is a good idea to keep a list of what tests are needed and when, so you can help keep on top of the recommended schedule.

    What to monitor

    Checking your blood glucose

    Your diabetes health care team will recommend how often you should test your blood glucose. Checking your blood glucose, whether you use a blood glucose meter or continuous glucose monitoring, can help you learn how your food, physical activity and medications impact your levels so that you can make appropriate changes if needed.

    Here are some key appointments that will need to be scheduled:

    Diabetes check-ups with your diabetes health practitioner every 3 – 6 months. During these visits the healthcare provider will check:

    Blood pressure

    High blood pressure usually has no signs or symptoms, therefore the only way to know if your blood pressure is high is to have it checked. The blood pressure target for people with diabetes is less than 130/80mm Hg.

    Weight

    Achieving an optimal weight is one of the best ways to help reach blood glucose targets. When you are at a healthy body weight, your insulin works better. Losing even 5-10% of your body weight can make a big difference.[/vc_column_text][read-also-article article-slug=”warning-signs-for-diabetes-related-heart-problems”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont2′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    Feet

    Foot care is especially important for people with diabetes since they are more likely to develop neuropathy (nerve damage) which can affect the sensation in the feet. As a result, extreme cold or heat may not be felt under the feet, as well as foreign objects such as pebbles. In addition, poor blood circulation means that it is harder for blood to reach sores and wounds in order to heal them. Therefore, it is extremely important to look for cuts and sores that don’t heal and have them treated promptly. Have your feet checked by a healthcare provider at least once per year.

    Additionally, the following tests should be scheduled:

    • An A1C test at least every 3-6 months, to measure your overall blood glucose control. This should be less than or equal to 7.0% for most people.
    • A cholesterol (LDL-C) test at least once a year, to measure ‘bad’ LDL cholesterol. LDL should be 2.0mmol/L or less.
    • A urine test once a year, to check for a protein called ‘albumin’, which can indicate early kidney damage
    • An eye screening test that looks at the blood vessels in your eyes should be done regularly (usually once per year)
    • Regular dental check-ups should also be scheduled at least every six months, to check for signs of gum disease or fungal infections.

    It is important to keep regular appointments since complications can start without warning. By being on top of the appointments you need, you are one step closer to a healthier path of managing your diabetes.[/vc_column_text][read-also-article article-slug=”diabetes-tests-what-do-they-mean-when-are-they-done”][/vc_column][/vc_row]

  • Time to check in

    Time to check in

    [vc_row][vc_column][vc_column_text]When it’s time to check in with your diabetes healthcare team, make sure you come prepared!

    Whether it’s a daily blood sugar check, or an annual eye examination, regular testing is a very important part of your diabetes management. While all the tests and check-ups can be stressful and time-consuming, by breaking it down into manageable tasks you might find the process more agreeable. For example, try tracking daily, weekly, monthly and yearly tasks.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont1′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    Daily diabetes check-ups

    • Blood sugar testing. Your healthcare team will help you determine how often you should check your blood sugar levels. People with type 1 diabetes must check their levels multiple times a day, however, those with type 2 diabetes usually may not need to check as often. This depends on if their sugars are under control and the medication they are on doesn’t put them at risk of low blood sugars.
    • Foot inspection. Because people with diabetes are at risk for neuropathy (nerve damage, especially in the legs and feet), foot care is very important. Inspect your feet every day, and look for:
      • Cuts, cracks, blisters or calluses
      • Changes in the colour or temperature of your feet
      • Redness, tenderness or swelling
      • Ingrown toenails
      • Changes to the size or shape of the foot
    • Blood pressure testing. While your healthcare team will check your blood pressure during your diabetes-related visits, you can also check it with a home monitoring system. Checking your blood pressure at home is generally a better reflection of your usual blood pressure than when it’s done in your doctor’s office.

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    Diabetes check-ups every three months

    When you visit your healthcare team every three months, they should check in with you about the following

    • A1C test. This is a blood test done in a laboratory, which your doctor will order. The A1C test is a measure of your blood sugar levels over the past three months. It is not a fasting test.
    • Blood pressure. People with diabetes are at higher risk of hypertension (high blood pressure). That’s why it’s important to monitor your blood pressure level regularly, and take action if it is high. In this event, your doctor may prescribe medications to help lower your blood pressure.
    • Weight. Maintaining a healthy weight is one of the most important ways you can keep your blood sugar at target, and prevent or delay diabetes complications. If you are overweight, your healthcare team can help you with some suggestions for losing those extra pounds.
    • Diet and physical activity. Eating a healthy diet and exercising regularly are two of the most important things you can do to manage your diabetes. Talk to your healthcare team to learn about tips for good nutrition and physical activity regimens.
    • Mental health. People with diabetes are at higher risk of mental health issues than those who don’t have the disease. This includes conditions such as stress, anxiety, depression and “diabetes distress.” You should always talk with your healthcare team if you are having emotional difficulties.

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    Annual diabetes check-ups

    At least once per year, the following should be done:

    • Cholesterol test. Your healthcare team will order a blood test to determine what your level is. If your cholesterol is high, they may prescribe medication to help lower it.
    • Kidney function test. A kidney function test is important, as people with diabetes are at greater risk of kidney disease. There are two tests. One is a blood test to measure flow through the kidney and the other is a urine test to look for protein that may be leaking through the kidney if there is kidney damage.
    • Eye exam. Since people with diabetes are at risk for retinopathy, you should visit an eye care specialist (e.g. an optometrist or an ophthalmologist) every year for an eye test.
    • Foot exam. While it’s important that you inspect your feet every day, your healthcare team will also do a thorough check annually.

    [/vc_column_text][read-also-article article-slug=”finding-your-footing-with-diabetes”][vc_message]Need a list of what to monitor? Download and print The What, Why and How of Diabetes Monitoring.[/vc_message][vc_message]Download and print your own personal Diabetes Monitoring Record[/vc_message][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    Be prepared!

    Use these quick tips to make the most of your diabetes check-up:

    1. Bring a list of all prescription medications, including over-the-counter remedies, vitamins and minerals, and herbal supplements.
    2. Bring your blood sugar readings or a download of your readings from your blood glucose meter. Your healthcare team can examine your logbook or review the levels from your meter and look for patterns of highs and lows, and how to avoid them.
    3. Prepare your questions. It’s easy to forget everything you want to say or ask your healthcare team, so preparing a list of questions ahead of time will help ensure that you get all the answers you need.

    Questions you might consider asking your doctor

    1. Are there any new apps I can use to track my progress?
    2. Are there any new medications I should take?
    3. How does high cholesterol affect me?
    4. How often should I check my blood pressure?
    5. What else can I do to prevent complications?
    6. Could you recommend a referral for a dietitian, therapist or personal trainer?

    [/vc_column_text][read-also-article article-slug=”/diabetes-tests-what-do-they-mean-when-are-they-done”][/vc_column][/vc_row]

  • Diabetes tests…What do they mean? When are they done?

    Diabetes tests…What do they mean? When are they done?

    [vc_row][vc_column][vc_column_text]Good diabetes care that helps you avoid complications, involves regular “diabetes-focused” visits with your family doctor, nurse practitioner or diabetes specialist.

    It helps to have your laboratory tests done prior to these visits, so the diabetes team can assess how you are doing.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont1′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    What are these diabetes tests and what do they mean?

    A1C
    •  This is a blood test that should be done every three months. It is NOT a FASTING blood test, so people can go for this any time of the day. It is not a blood sugar test, but it does give an average of what an individual’s blood sugar has been for the past three months. For most people this should be about 7%. But talk to your doctor to find out the specific recommended target.  For some people who may be elderly or prone to low blood sugars, the target may be higher.  For those who can easily reach 7% or less with diet, exercise and medications that don’t cause the blood sugar to go below normal, the A1C target may be lower than 7%.

    Cholesterol
    •  This is usually measured once a year for type 2 diabetes. For those who are younger and have type 1, it may be measured less often. LDL cholesterol is the one most associated with heart disease and for most people the target is less than 2 mmol/L. Often people require medication to reach this target.

    ACR (albumin/creatinine ratio)
    •  This is a urine test that can be done at any time. It is done once a year and is a measure of both kidney and heart damage.[/vc_column_text][read-also-article article-slug=”whats-the-difference-between-a1c-and-blood-sugar”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Blood Glucose Meter Check
    •  This is a blood sugar blood test at the same time as a meter reading. You will need to bring your own meter to the appointment. When they follow up with your doctor, you will find out if your meter is accurate. This should be done once a year and it should be within 15% of the laboratory test.

    Blood Pressure
    •  At each visit, blood pressure should be taken. The target for most people is less than 130/80.  A lot of people have higher blood pressure in the doctor’s office than at home, so it’s a good idea if you have higher blood pressure to get your own blood pressure monitor and let the doctor know what readings you get at home.

    Foot Exam
    •  Once a year the care team should examine your feet. Especially to see if you have lost any feeling. This is often done with a “mono-filament” which is a little piece of nylon that just barely touches the skin. If you can feel this, you are much less likely to have an amputation.  Chronically high sugars can lead to a loss of this ability to feel.

    Ensuring that you have these diabetes tests on a regular basis and keeping track of them can go a long way to help reduce your risk of complications. You can keep track of all your diabetes health check results by using this handy downloadable monitoring record.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][read-also-article article-slug=”diabetes-health-checks-to-add-to-your-calendar”][/vc_column][/vc_row]

  • Self-monitoring your blood pressure

    Self-monitoring your blood pressure

    [vc_row][vc_column][vc_column_text]High blood pressure – also called hypertension – increases the risk of heart disease and stroke. It’s important to keep blood pressure within diabetes management targets. If you have continued high blood pressure, the diabetes team may recommend self-monitoring your blood pressure in between regular check-ups. 

    This is easy to do, using the blood pressure machines in pharmacies. In some pharmacies, the pharmacist does the blood pressure testing for customers. In others, machines let you test your blood pressure yourself. If you have questions about how to use a machine like this, ask the pharmacist for assistance.

    Blood pressure monitors can also be purchased for testing in the home, which we will discuss further on.

    Whichever route is taken, here are some key facts to note about blood pressure testing.

    How blood pressure is measured

    Blood pressure is measured using two numbers. For example: 124/84. The first number is called systolic pressure. This occurs when the heart contracts. The second number is called diastolic pressure. This occurs when the heart relaxes between beats and fills with blood. Both these numbers are important.

    The usual target for people with diabetes is to have blood pressure below 130/80. Cases can vary however, so it’s important to follow the specific target set by the diabetes healthcare team.

    Getting ready for testing

    Be aware that blood pressure readings swing higher or lower at different times of day. For most people, readings are usually higher in the morning and go down over the course of the day. Ask the diabetes team what time of day would be best for testing.

    If in-home testing is required, this may need to be done twice in the morning and twice in the evening for 7 days before a healthcare appointment. In this case, the readings should be recorded in a log.

    Here are some tips to help prepare for an accurate blood pressure reading:

    • For 30 minutes before testing, don’t smoke or exercise, or use any medications that might raise the blood pressure.
    • Don’t drink caffeine for 30 minutes before testing.
    • Sit and rest quietly for 5 minutes before testing.
    • Sit with your feet flat on the floor, back and arm supported, and arm at heart level
    • Don’t wear tight clothing during testing.
    • If possible, put the cuff on a bare arm. If this isn’t possible, put it over a very thin sleeve.
    • Don’t talk during testing.
    • Avoid testing when you are particularly stressed or upset.

    Blood pressure monitoring in the home

    Having a blood pressure monitor in the home can be very valuable for a number of reasons, particularly if a record is kept to be shared with the diabetes team. A record of blood pressure readings over time can give a more accurate picture of the blood pressure pattern. Importantly, it can show if medications and lifestyle changes are having the desired impact. Record your own blood pressure readings whether they are done at the pharmacy or in your home.

    Before buying a blood pressure monitor, get advice from the diabetes team. Ask a pharmacist to help you choose the type that is right for you, and that has the right size of cuff for your arm. Click here for a list of blood pressure monitors recommended by Hypertension Canada. [/vc_column_text][/vc_column][/vc_row]