There are many treatment plans,
or guidelines, out there; depending on which source you
review, you may find similar or completely different lists. Remember that insurance plans
operate under different criteria than doctors do. Their
goal is to operate a business while
a
doctor's goal is to treat your health and medical problems.
Frequency
of visits:
Most physicians and diabetes experts suggest seeing your doctor every three
months.
During theses visits you may have lab ordered or done in-house; which should include
a HBAIC, a accucheck (or review of your home BS
checks and glucometer).
A foot exam for
sensory testing and evaluation for calluses,
wounds and nail health should be included.
Blood
pressure is monitored and should be kept <120/80.
EKG's: at least once a year for screening, as
diabetics can develop
heart disease often without many symptoms.
Lab:
HBAIC: the goal in under 7, I prefer closer to 6.
AACE (American Association of Clinical Endocrinologists: http://www.aace.com)
recommends <6.5 (less
than)
Lipids: generally, these are done about
every 6 months depending on need or
change of medications. Guidelines can be considered the following:
LDL between 80-100, depending on other medical history,
HDL > (means greater than) 40-50,
Total Cholesterol <(means less
than) 200, and triglycerides <100.
Renal (kidney) function and liver functions every
3 months
(especially
if you are on medications that affect or are effected),
unless there are problems that need more frequent monitoring.
Urine analysis: generally are checked at least twice a year to monitor
for protein and glucose. If these are found,
more specific tests such as a
microalbuminurua or 24 hour urine might be ordered.
Blood sugars: recommended
fasting <120 and postprandial <150.
Diet and Exercise:
This is very important and my patients know I nag them about these factors.
The saying "you are what you
eat" really is meaningful in a diabetic.
Food can be poison to a diabetic.
Food and eating should not be a hobby for you!
Websites:
http://www.aace.com
http://www.diabetes.org/home.jsp
http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/index.html
