Diabetes: Types of Medical Care to Help You Manage

Living with and managing diabetes, also known as diabetes mellitus, can be a challenge.

• An endocrinologist. This is a physician who specializes in diabetes.
• Nurses.
• An expert in healthy eating called a dietitian.
• A diabetes care and education specialist.
• An eye doctor.
• A foot specialist called a podiatrist.

How to manage your diabetes

Managing your diabetes involves a lot of steps to keep you healthy. Your team will follow guidelines to help you get the best care possible. Here are some general guidelines for managing your diabetes:

Physical exams

• Measuring your height, weight, and body mass index (BMI).
• Checking your blood pressure. Your target blood pressure may vary based on things like your age and health conditions.
• A thyroid exam.
• A skin exam.
• Screening for nerve damage. This may include checking your hands, feet, and arms for:
  • Pain.
  • Tingling or numbness.
  • Weakness.
• An exam to check your feet. They'll be checked for cuts, bruises, redness, blisters, sores, or other problems.
• Screening for blood vessel problems. This may include checking the pulse and temperature in your legs and feet.

Blood tests

Depending on your treatment plan, you may have these tests:

• Hemoglobin A1C (HbA1C). This test gives information about your blood sugar levels, also called glucose levels, over the past 2–3 months. It's used to adjust your treatment plan, if needed.
• Lipid testing. This includes total cholesterol, LDL and HDL cholesterol, and triglyceride levels.
  • The goal for LDL is less than 100 mg/dL (5.5 mmol/L). If you're at high risk for problems, the goal is less than 70 mg/dL (3.9 mmol/L).
  • The goal for HDL is 40 mg/dL (2.2 mmol/L) or higher for males, and 50 mg/dL (2.8 mmol/L) or higher for females.
  • The goal for triglycerides is less than 150 mg/dL (8.3 mmol/L).
• Liver function tests.
• Kidney function tests.
• Thyroid function tests.

Dental and eye exams

• Visit your dentist two times a year for checkups.
• Get eye exams as recommended by your provider. This may include:
  • If you have type 1 diabetes, get an eye exam within 5 years after you're diagnosed. Then get exams once a year after your first exam.
    • Children with type 1 diabetes should get an eye exam when they're 11 years old or older and they've had diabetes for 3–5 years. After the first exam, they should get an eye exam every 2 years.
  • If you have type 2 diabetes, get an eye exam as soon as you're diagnosed. Then get one every 1–2 years after your first exam.

Shots or vaccines

• Everyone aged 6 months and older should get a flu shot every year.
• People at least 2 years old who have diabetes should get the pneumonia vaccine.
• All adults who get diagnosed with diabetes should get the hepatitis B vaccine.

For all other vaccines, follow the recommendations from the Centers for Disease Control and Prevention (CDC) based on your age.

Mental and emotional health

Screening for eating disorders, anxiety, and depression is suggested at the time of diagnosis and then as needed.

If you show symptoms, you may need more evaluation. You may need to work with a mental health provider.

Follow these instructions at home:

Treatment plan

• How you're taking your medicines, including insulin.
• Any side effects you have.
• Your target goals for your blood sugar level.
• How often you check your blood sugar level.
• Lifestyle habits, such as:
  • Your activity level.
  • Any use of tobacco, alcohol, or other substances.

Education

• A certified diabetes care and education specialist. This person can help you manage your diabetes throughout your life.
• A dietitian who can help with your eating plan.
• An exercise specialist who can discuss your activity level and exercise plan.

General instructions

• Take medicines only as told.

Where to find more information

• American Diabetes Association (ADA): diabetes.org
• Association of Diabetes Care & Education Specialists (ADCES): adces.org/diabetes-education-dsmes
• International Diabetes Federation (IDF): idf.org