As the year winds down, it’s time to start to think about scheduling your routine medical check-ups for the new year. Since our endocrinologists are usually our primary doctor, they can help by providing you a list of who to see and when your last appointment report was received. Your primary doctor will also keep a record of immunizations and booster shots so that you are protected from flu, tetanus, and pneumonia — conditions which any diabetic would be more than happy to avoid.
When you leave the doctor’s office you may well be asked to go to a lab to have blood drawn and to pick up a collection bottle for a 24 hours urine collection. Knowing what we do about the long term complications of diabetes, it is important that we are aware of our cholesterol levels and have a complete blood analysis as well as checking on our kidney functions with creatinine clearance and urine analysis tests. Before leaving, ask questions that are of concern to you, and also find out how often you need to be seen. Then set up appointments for the year, or at least for the time your doctor has their appointment books made up. Since your doctor visits are hopefully routine, you will need to call well in advance to make the appointment.
Tests for Women
For women, a mammogram and a gynecological check-up need to be done. You will have a PAP test to make sure you don’t have cervical cancer, as well as an exam to rule out any abnormalities. Since your doctor knows of your diabetes, he or she will most probably ask about recurrent yeast infections. If you are of child bearing age and thinking of having a child, it is important to work with your obstetrician before you try to become pregnant, as well as after. Poor glucose control in the earliest stages of pregnancy can cause abnormalities in fetal development.
It is recommended that people with diabetes have a complete eye exam every year. Diabetic retinopathy (damaged blood vessels at the back of the eye) can lead to blindness. Although some people with the condition notice a change in their vision, some people will not experience any early symptoms. As you have diabetes for more years, the chances of developing retinopathy increases, but with laser surgery, it can usually be controlled.
You’ll also be examined for glaucoma as diabetics have twice the risk of developing this condition. If glaucoma is not treated, pressure in the eye can lead to blindness. Lastly, the doctor will check for cataracts, another condition that diabetics are twice as likely to develop as non diabetic.
Early treatment of all of these conditions can prevent vision loss. When your eye exam is finished you can be rest assured that you and your doctor are on top of any problems. For more information including how to find an eye care professional, visit the web site of the National Eye Institute.
A trip to the dentist rounds out the list of necessary appointments. You do not want to develop infections that may infringe on glucose control, or which may spread throughout the body. If you also have cardiovascular disease, check with your dentist about the need to take amoxicillin or another antibiotic prior to having your teeth cleaned to avoid an infection of a heart valve.
Other doctors to consider seeing, depending on your health, would be the cardiologist, nephrologist, urologist, or podiatrist. Having been to these specialists, you will know what to expect. Just make sure that all reports are sent to your primary doctor, and that you speak to that doctor about coordinating care, medicines, and interventions.
Taking responsibility for your health is the first but most important step to living a life as free from complications as possible. The hard part is picking up the phone. The easy part is the moment that you leave the doctors’ offices, knowing that you won’t see them for six months or a year. Also how good to know that if by chance you need their expertise, you will not be a stranger, but rather someone whose medical history is well known.
If you feel that your primary care doctor is too busy to give you the care and attention you would like, consider switching to a diabetes clinic. In a new study reported in an early spring edition of Diabetes Care, patients of diabetes clinics reported better blood glucose control, more accurate self-monitoring of blood glucose, more referrals for diabetes education, and more thorough examinations of the eyes and feet by their diabetes physician.