Back to Basics
Basic tests for people with diabetes that should be done regularly include: height, weight, thyroid exam, injection/infusion site assessment, a visual + microfilament foot exam, hypoglycemia assessment, depression screening, alcohol/tobacco/drug use, sexual issues/contraception, digestive assessment (to screen for celiac disease in type 1s), nutritional habits, and diabetes self-management skills.
Blood tests include: A1c, thyroid (TSH + free T3 + free T4), antithyroid antibodies and celiac antibody panel (done once in type 1 diabetes, and then as-needed dependent on symptom presentation), and cardiovascular tests.
Baseline Cardiovascular Tests
Baseline cardiovascular tests include: blood pressure, HDL (good) & LDL (bad) cholesterol (total value is less useful), and triglycerides. However, medicine is realizing that cholesterol tests are less useful given their poor accuracy of predicting cardiovascular risk, given the fact that the majority of people experiencing heart attacks have normal cholesterol levels.
Other Blood Tests to Assess Cardiovascular Risk
Thus other blood tests to ask your doctor about to assess your cardiovascular risk are lipoprotein(a), LDL-P (particle number), apolipoprotein B, and inflammation markers, such as hsCRP. Further examination can be done via a treadmill stress test, a coronary artery calcium score + calcium density study, and/or a CT angiography of the coronary arteries (to check for blockage). The determination of which tests are applicable to you must be determined via a discussion with your doctor given your individual characteristics and risk factors.
Urine tests to exam kidney function include: microalbumin, and others are creatinine clearance, urine albumin-to-creatinine ratio, and estimated glomerular filtration rate (GFR).
Further exams include that should be done by a specialist include: a full-dilation eye exam.
Other Auto-Immune Conditions Common in Type 1 Diabetes
Lastly, once someone has one auto-immune condition, such as type 1 diabetes (type 2 is not auto-immune), there is a higher chance for having another. The most common ones associated with type 1 are auto-immune thyroiditis, called Hashimoto’s, and celiac disease, which is an auto-immune reaction against gluten thus gluten must be eliminated from the diet. There is also a condition called common variable immunodeficiency that can be hard to diagnosis. CVID is an immune disorder characterized by recurrent infections and low antibody levels, which can be detected by a blood test. Symptoms can include high susceptibility to infections, or chronic lung disease, or inflammation and infection of the gastrointestinal tract however, symptoms vary greatly between people. Thus periodic assessment of other auto-immune conditions may be warranted in type 1’s.
More information can be found at the ADA website
Finally, a key question that is often left out of doctor visits is this very important question, “How are you doing with all of this?” Managing diabetes takes a lot. I understand! I myself have had it for 37 years, since I was 7. Sometimes the most important support we need is simply to talk with someone who understands how challenging it can be. If you don’t already have this kind of emotional support, I encourage you to seek it out. If you have questions for me, email email@example.com
To your health!
Dr. Jody Stanislaw is a 2007 Bastyr University graduate. She works entirely via phone with patients all around the country.
Being a type 1 diabetic since the age of 7, she specializes in Diabetes care and is an expert at helping patients achieve optimal glucose control. She also works with the general population, advising patients on the naturopathic approach of treating today’s most common ailments.
Her focus on mind/body is present in every appointment. In her very popular intensive program, patients receive weekly calls with her over a 3 month period, allowing them to make dramatic transformations in their overall health & wellbeing. This structure allows the many levels of a patient’s needs to be addressed…physical, emotional, nutritional, and more…leaving them happier and healthier than ever before. Sign up for a free introductory phone consultation with Dr. Stanislaw here: www.consultwithdrjody.com