Diabetes and Standards of Medical Care

Diabetes is complicated. You may find that your diabetes team includes a dietitian, nurse, diabetes educator, eye doctor, and more. To help everyone know what is going on and to help you get the care you deserve, the following schedule of care was developed to help keep you on track. Below are the tests, exams, vaccines, medicines, education, and plans you will need.

HbA1c test

This test shows how well you have controlled your glucose over the past 2–3 months. It is used to see if your diabetes management plan needs to be adjusted.

  • It is performed at least 2 times a year if you are meeting treatment goals.

  • It is performed 4 times a year if therapy has changed or if you are not meeting treatment goals.

Blood pressure test

  • This test is performed at every routine medical visit. The goal is less than 140/90 mmHg for most people, but 130/80 mmHg in some cases. Ask your health care provider about your goal.

Dental exam

  • Follow up with the dentist regularly.

Eye exam

  • If you are diagnosed with type 1 diabetes as a child, get an exam upon reaching the age of 10 years or older and have had diabetes for 3–5 years. Yearly eye exams are recommended after that initial eye exam.

  • If you are diagnosed with type 1 diabetes as an adult, get an exam within 5 years of diagnosis and then yearly.

  • If you are diagnosed with type 2 diabetes, get an exam as soon as possible after the diagnosis and then yearly.

Foot care exam

  • Visual foot exams are performed at every routine medical visit. The exams check for cuts, injuries, or other problems with the feet.

  • A comprehensive foot exam should be done yearly. This includes visual inspection as well as assessing foot pulses and testing for loss of sensation.

  • Check your feet nightly for cuts, injuries, or other problems with your feet. Tell your health care provider if anything is not healing.

Kidney function test (urine microalbumin)

  • This test is performed once a year.

  • Type 1 diabetes: The first test is performed 5 years after diagnosis.

  • Type 2 diabetes: The first test is performed at the time of diagnosis.

  • A serum creatinine and estimated glomerular filtration rate (eGFR) test is done once a year to assess the level of chronic kidney disease (CKD), if present.

Lipid profile (cholesterol, HDL, LDL, triglycerides)

  • Performed every 5 years for most people.

  • The goal for LDL is less than 100 mg/dL. If you are at high risk, the goal is less than 70 mg/dL.

  • The goal for HDL is 40 mg/dL–50 mg/dL for men and 50 mg/dL–60 mg/dL for women. An HDL cholesterol of 60 mg/dL or higher gives some protection against heart disease.

  • The goal for triglycerides is less than 150 mg/dL.

Influenza vaccine, pneumococcal vaccine, and hepatitis B vaccine

  • The influenza vaccine is recommended yearly.

  • The pneumococcal vaccine is generally given once in a lifetime. However, there are some instances when another vaccination is recommended. Check with your health care provider.

  • The hepatitis B vaccine is also recommended for adults with diabetes.

Diabetes self-management education

  • Education is recommended at diagnosis and ongoing as needed.

Treatment plan

  • Your treatment plan is reviewed at every medical visit.