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Diabetes: 3 Commonly Missed Tests

Less Than Half of U.S. Diabetes Patients Get All 3 Annual Tests
WebMD Health News
Reviewed by John A. Seibel, MD

April 28, 2006 -- The U.S. government reports that most adults with diabetesdiabetes aren't getting three annual medical tests recommended for diabetes patients.

Those three tests are:

  • Hemoglobin A1c: A blood test that checks average blood sugar level for the past two to three months.
  • Dilated eye exam: An eye care professional uses eye drops to temporarily widen, or dilate, the black part of the patient's eyes (pupils) to see inside the eyes. Uncontrolled diabetes can damage the eyes, harming vision and possibly leading to blindness. Diabetes is the leading cause of adult blindness in the U.S.
  • Foot exam: A check of the foot's nerves and blood circulation. Uncontrolled diabetes can lead to foot problems that may eventually require amputation. Diabetes causes most of the nontraumatic amputations in the U.S.

Who Got Tested

In 2003, about 14 million civilian, noninstitutionalized U.S. adults were reported to have diabetes diagnosed by their doctor. Nearly 42% of them got all three tests, the researchers estimate.

About 50% got one or two tests. About 5% didn't get any of the tests. The rest didn't know if they had gotten those tests or not.

So says a report by Anita Soni, PhD, of the Agency for Healthcare Research and Quality (AHRQ). The AHRQ is part of the U.S. Department of Health and Human Services.

People who got all three tests were more likely to be white, to have medical insurance, and to be 65 or older, the report shows.

As of 2005, about 6 million people in the U.S. didn't know they had diabetes, according to the National Diabetes Information Clearinghouse, a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is a branch of the National Institutes of Health.

Doctors can check for diabetes with a simple blood test. Being overweight and having a family history of diabetes may make diabetes more likely.

Must-Have Medical Tests for People With Diabetes

The NIDDK lists these tests that people with diabetes should get:

  • Hemoglobin A1c test: Get this test at least twice a year. It checks your average blood sugar over the past two to three months.
  • Blood lipid (fats) test: A blood test of cholesterol and triglyceridestriglycerides.
  • Kidney function tests: Get a urine test that checks for protein in urine at least once a year. Get a blood test for creatinine, a waste product, at least once a year. These tests screen for kidney problems.
  • Blood pressure: Get your blood pressure checked at every medical appointment.
  • Dilated eye exam: See an eye care professional once a year for a complete eye exam.
  • Foot exam: At every medical appointment, get your feet's nerves and blood circulation.

Caring for your teeth and monitoring your weight are also important for people with diabetes (and for everyone else).

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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