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.

A1c test

  • Performed at least 2 times a year if you are meeting treatment goals.

  • Performed 4 times a year if therapy has changed or if you are not meeting therapy/glycemic goals.

Aspirin medicine

  • Take daily as directed by your caregiver.

Blood pressure test

  • Performed at every routine medical visit. The goal is less than 130/80 mm/Hg.

Dental exam

  • Get a dental exam at least 2 times a year.

Dilated eye exam (retinal exam)

  • Type 1 diabetes: Get an exam within 5 years of diagnosis and then yearly.

  • Type 2 diabetes: Get an exam at diagnosis and then yearly.

All exams thereafter can be extended to every 2 to 3 years if one or more exams have been normal.

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.

Kidney function test (urine microalbumin)

  • 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 tell the level of chronic kidney disease (CKD), if present.

Lipid profile (Cholesterol, HDL, LDL, Triglycerides)

  • Performed once a year for most people. If at low risk, may be assessed every 2 years.

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

  • The goal for HDL is higher than 40 mg/dl for men and higher than 50 mg/dl for women.

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

Flu vaccine, pneumonia vaccine, and hepatitis B vaccine

  • The flu vaccine is recommended yearly.

  • The pneumonia vaccine is generally given once in a lifetime. However, there are some instances where another vaccine is recommended. Check with your caregiver.

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

Diabetes self-management education

  • Recommended at diagnosis and ongoing as needed.

Treatment plan

  • Reviewed at every medical visit.