Checking you out from head to toe

Tracking your glucose is just one of the health checks that can help you stay well and avoid diabetes complications. Make sure you don’t miss out.

Glucose tests, carbohydrate counting, insulin injections: it can be hard sometimes to keep the bigger picture of diabetes treatment in mind. The aim of your care plan is to help you avoid two main types of complications:1

  • Macrovascular (affecting heart and arteries)
  • Microvascular (affecting eyes, kidneys and nerves)

Short-term side-effects of diabetes, such as having a hypo, are easy to spot. But others can develop slowly over time if your diabetes isn’t well controlled. That’s why your diabetes care team should offer you regular checks to spot any early signs of problems. Here’s what you can expect:2  

Blood glucose test (HbA1c)

Your HbA1c test is different from the glucose tests you do yourself because it measures the level of glucose in your bloodstream over a 2-3 month period, rather than daily ups and downs. It measures glycated haemoglobin, a substance that’s made when glucose sticks to red blood cells. You’ll agree a target HbA1c level with your diabetes care team –and you’ll review it together regularly, to see how you’re doing with your diabetes control.3

What can I do?

Sticking to your diabetes treatment plan and avoiding highs and lows in your glucose on a daily basis, as far as you can, is the best way to keep your HbA1c on track. Choosing a glucose testing system that allows you to spot trends and match highs and lows against your food, insulin and activity can help you and your care team pinpoint how to fine-tune your diabetes routine.

Blood pressure check

High blood pressure increases your risk of developing diabetes complications such as heart disease, stroke and kidney disease.4 People with Type 2 diabetes are much more likely to have high blood pressure than those with Type 1, but it’s important for everyone with diabetes to have regular blood pressure checks.4

What can I do?

Eating healthily, cutting down on salt, exercising regularly and losing weight if necessary can all help lower blood pressure and there are many medications that can help too.4

Cholesterol check

Cholesterol is a fatty compound that circulates in your blood and is important for good health. There are two types of cholesterol: high-density lipoprotein (HDL) and low-density lipoprotein (LDL). Too much LDL and too little HDL cholesterol in the bloodstream can make blood ‘sticky’ and increase your risk of heart disease and stroke, so it’s important to have it checked (by a blood test) and lower it if necessary.5

What can I do?

Eating less saturated fat and more fibre can help control cholesterol and there are effective medications, such as statins, that your GP can prescribe.6

Eye screening

Everyone with diabetes is offered a special eye test once a year to screen for diabetic retinopathy.2 This is a complication that’s caused when high glucose levels damage the tiny vessels at the back of the eye (retina) over time. If not detected and treated, diabetic retinopathy can cause blindness.7

What can I do?

Keeping your glucose, blood pressure and cholesterol levels within target range is the best way to reduce your risk of retinopathy. Eye problems can be treated with medication, laser treatments and surgery. 

Foot and leg check

Over time, high glucose levels can damage the nerves in your feet and legs, leading potentially to loss of sensation, and increasing your risk of developing ulcers and infections. These can be very hard to treat and in severe cases can lead to amputation.8

A specialist should examine your feet at least once a year – more often if you have any problems – to check for signs of inflammation or infection and to test the pulse and feeling in each foot.8

What can I do?

Daily foot care is important for everyone with diabetes. Always wear well-fitting footwear, avoid pressure and rubbing on your feet, and don’t ignore problems like corns, calluses and blisters.8

Kidney tests

Diabetes can cause complications affecting your kidneys in three ways:9

  • Damaging the tiny vessels that filter waste (diabetic nephropathy)
  • Restricting the arteries to the kidneys (renovascular disease)
  • Increasing your risk of urinary tract infections.

Kidney problems can develop over many years and may cause no symptoms until the damage is done. An annual test to check for particles of protein in your urine can help spot the early signs of disease and catch it early.9

What can I do?

Keeping your glucose, cholesterol and blood pressure under control, and giving up if you smoke, can help maintain healthy kidneys. Medications are available to treat kidney disease but in severe cases, dialysis or a transplant may be required.9  

What else?

You can also ask your diabetes care team for specialist support if you have a health-related problem that’s bothering you. They can help you with:2 

  • Advice on healthy eating
  • Courses on managing your diabetes
  • Emotional and psychological issues
  • Giving up smoking
  • Sexual health
  • Pregnancy planning
  • Advice if you need a hospital stay

 

References

1. Fowler, MJ, Microvascular and Macrovascular Complications of Diabetes, Clinical Diabetes, 2008; 26(2): 77-82.

2. Diabetes UK 2019, 15 healthcare essentials checklist, accessed 25 March 2019, https://www.diabetes.org.uk/resources-s3/2018-07/15-Healtcare-essentials.pdf.

3. Diabetes UK 2019, Managing your diabetes. HbA1c, accessed 25 March 2019, https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/hba1c/.

4. Blood Pressure UK 2008, Diabetes, accessed 29 March 2019.

5. Diabetes UK 2019, Cholesterol and diabetes, accessed 29 March 2019, https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/managing-other-medical-conditions/cholesterol-and-diabetes/.

6. NHS 2018, High cholesterol, accessed 25 March 2019, https://www.nhs.uk/conditions/high-cholesterol/.

7. NHS 2018, Diabetic retinopathy, accessed 25 March 2019, https://www.nhs.uk/conditions/diabetic-retinopathy/.

8. National Institute for Health and Care Excellence 2015, NG19: Diabetic foot problems: prevention and management, accessed 25 March 2019, https://www.nice.org.uk/guidance/ng19/ifp/chapter/foot-checks-for-people-with-diabetes/.

9. Kidney Care UK 2019, Diabetes, accessed 25 March 2019, https://www.kidneycareuk.org/about-kidney-health/conditions/diabetes/.

 

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