William Osler, one of the founding professors of Johns Hopkins Medicine, once said, “Medicine is a science of uncertainty and an art of probability.”
An ever-evolving landscape, the field of healthcare bears witness to new developments and discoveries each day. To keep up with the influx of new information and research in the field of Diabetes, the American Diabetes Association® (ADA) has unveiled new guidelines for patients and doctors each year since 1989.
This year marked the start of even more up-to-date information, using digital updates to their Standards of Care as the Professional Practice Committee sees fit.
Patients who are on an insulin regimen to successfully manage their diabetes should undergo Hemoglobin A1C (hA1C) testing at least two times per year. For those who are not meeting glycemic goals set forth by their doctor, or have difficulties regulating their glucose levels, A1C testing is recommended to take place every three months. According to the National Institute of Diabetes and Digestive and Kidney Diseases, this blood test that provides accurate information about your average levels of blood sugar has been beneficial for discovering prediabetes and type 2 diabetes, as well as monitoring those who have already been diagnosed to avoid future complications.
Foot problems are synonymous with diabetes. Over time, the disease can lead to diabetic neuropathy, a condition caused when high blood sugar damages the body’s nerve fibers. Marked by tingling and pain in the feet, diabetic neuropathy can range from mild to disabling; in extreme cases, patients can experience loss of feeling in the lower extremities. Blood flow to the feet is often affected by diabetes, which can cause gangrene, foot ulcers, and a rare disorder known as “Charcot’s foot” that affects the physical characteristics of feet. For these reasons, the most recent 2018 guidelines recommend that diabetics have their feet checked no less than twice per year.
The ADA has recently added more stringent guidelines surrounding ocular health. Diabetics should now have their eyes examined by an ophthalmologist every year. Part and parcel of blood flow issues, is a condition known as diabetic retinopathy – which leads to damage of the small blood vessels, including those in the eye’s retina. One of the most common causes of blindness, this ailment can be avoided or lessened through stricter glycemic regulation, as well as lowered blood pressure. Seeking the advice of an eye doctor as a preventive measure is helpful for catching problems in their early stages. According to the U.S. National Library of Medicine, a dilated retinal exam is often used by healthcare providers to inspect the blood vessels in the middle or front of the eye.
Chronic elevated levels of blood sugar may lead to the build-up of wastes and fluid in the kidneys. Rather than filter through as they normally would in a healthy body, this stagnant waste can remain in the blood, causing damage known as diabetic nephropathy. Because poor kidney function often shows no outward symptoms in its earlier stages, it’s best to be screened with a urine lab test once per year.
The endocrinologists at Intercoastal Medical Group offer many services to assist their patients in the diagnosis and management of diabetes. Well-versed in the most up-to-date information, their staff is managed by a nurse practitioner and certified diabetes educator. For more information about their technologies and treatments, find the location nearest you to schedule an appointment. You can also request an appointment online now.
1Care.diabetesjournals.org/content/41/Supplement_1/S4
2Aacc.org/publications/cln/cln-stat/2018/january/18/2018-standards-of-medical-care-in-diabetes
3Niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis/a1c-test#why
4Mayoclinic.org/diseases-conditions/diabetic-neuropathy/symptoms-causes/syc-20371580
5Niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems
6Diabetes.org/newsroom/press-releases/2017/ADA-Diabetic-Retinopathy.html
7Medlineplus.gov/ency/patientinstructions/000323.htm
8Medlineplus.gov/diabetickidneyproblems.html
