Because you have a complication from
type 1 diabetes, you need to have regular exams and
tests to monitor its progression and screen for new complications.
Schedule of exams and tests for diabetic complications
Tests if you do not have the complication
Tests if you have the complication
Eye disease (diabetic retinopathy)
Every year, have:5
- A complete dilated eye exam (ophthalmoscopy).
- Vision tests.
- Test for
If you are at low risk for vision problems, your
doctor may consider follow-up exams every 2 to 3 years.
As often as indicated,
- Pictures taken of the back of your eyes (fundus
photography), to monitor diabetic retinopathy and evaluate your
- Fluorescein angiogram, an imaging test,
to find any leaking blood vessels in the
Kidney disease (diabetic nephropathy)
Every year, have one of the
urine test for protein levels such as
microalbuminuria, macroalbuminuria, or the albumin to creatinine ratio. These
tests check for damage to your kidneys.
- Creatinine, a urine or blood test that
checks kidney function. Many laboratories will also provide the estimated glomerular filtration rate (eGFR).
As needed to check on your
- A 24-hour urine test to check the total amount of protein
leaking from your kidneys. A result of 300 mg or greater of protein in 24 hours
shows that the kidneys are leaking large amounts of protein
- Blood urea nitrogen (BUN) and
creatinine levels, to help estimate how well your
kidneys are removing wastes from the bloodstream.
- Blood electrolyte tests, to check whether your kidneys are
keeping normal levels of
electrolytes (salts) in your blood.
If you develop kidney failure, you may need other
tests. For more information, see the topic
Chronic Kidney Disease.
|Heart and blood vessel disease (macrovascular
During every medical appointment,
- Your blood pressure checked. Your blood pressure should be
less than 130/80 mm Hg.6
At least every year, or more often, if indicated,
- Cholesterol and triglyceride level test, to evaluate cholesterol levels in your
- Your LDL goal is less than 100 mg/dL. Your LDL goal may be lower-less than 70 mg/dL-if you have heart disease.
- If you are a man, your HDL goal is more than 40 mg/dL. If you are a woman, your HDL goal is more than 50 mg/dL.
- You want your triglycerides to be lower than 150 mg/dL.
- Exercise electrocardiogram (treadmill EKG or cardiac stress test) if you have not
been active and plan to begin a vigorous exercise program.
As indicated, have:
- Electrocardiogram (ECG or EKG), if you have had a
heart attack or have symptoms of heart disease.
- Exercise electrocardiogram (treadmill EKG or cardiac stress test).
For more information, see the topics
Heart Attack and Unstable Angina,
Peripheral Arterial Disease of the Legs.
Nerve disease (diabetic neuropathy)
Periodically, have a:
- Physical exam to check your response to light touch,
pressure, temperature, and vibration, particularly in your feet and legs.
Simple tests can screen for loss of sensation. Have these tests done on both
- Touching the end of your toe with a cotton wisp or a
thin plastic fiber (called a monofilament test) assesses your sense of light
touch or pressure.
- A cold metal tuning fork held to your leg evaluates
your sensation of temperature.
- A vibrating tuning fork touched to your foot assesses
your sensation of vibration.
- Checkup on your muscle strength and reflexes, especially
those in your ankles and knees.
- Careful exam of your feet for corns, calluses, infections,
injuries, or bone and joint problems. Have a complete exam of your feet at
least once a year.7
- Measurement of your blood pressure and pulse when lying
down, sitting, and standing.
As indicated, have:
- Electromyogram (EMG), to measure how well and how
quickly particular nerves and muscles are working.
autonomic neuropathy (internal functioning) are
specific to your symptoms, such as:
- Urine test and
urine culture, an
ultrasound of the bladder, X-ray of the entire urinary
system (intravenous pyelogram), or a
cystometrogram (which measures bladder storage
capacity), if you have a problem with bladder control.
- Endoscopy or
upper GI series, if you have digestive system
- Gastric emptying study, to evaluate how quickly your
stomach empties. Nerve damage from diabetes can slow this rate.