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Diabetic Protocols

In this post I continue exploring Type 2 Diabetes.  This time I share common labs and protocols followed when caring for the Type 2 Diabetic.  I hope this short message will help you understand the reasons for recurrent testing and follow up routines.

Diabetic Protocols:

1)Routine office visits every 3-6 months:  Usual tests for average blood sugar control only change… slowly over 3-4 months.  So a minimum of 3 month intervals is usually preferred for retesting.  This also allows for visitation time to discuss diet and lifestyle changes which make the most difference for diabetics.

2)Routine Labs:

  • Hga1c (Hemoglobin A-ONE-SEE) This is the average blood sugar test.  It measures your average sugar over a 3 month period.  It is a scaled number corresponding to blood sugar.  (Example:  Hga1c >6.5 usually indicates average blood sugar 126+.)
  • Fasting Cholesterol Panel:  Usually performed every 6 months.  Cholesterol is not disease but high readings or irregular cholesterol profiles provide clues as to the overall health of your metabolism.
  • Microalbumin:  Specialized urine test screening for leakage of vital proteins into the urine.  This protein leakage is an indicator of damage in the kidneys due to diabetes.

3)Lifestyle Factors

  • Diet:  At FFFM we believe that diet plays a huge role in diabetes development and recovery.  We in fact believe that patients can actually acheive Diabetic Remission.  (Listen here for Podcast on Diabetic Remission).  At nearly every visit you should be asked about meals, snacks, and your typical eating habits.  Eating simple sugars (Bread, cereals, potatoes, sweets, candy, sodas, and alchohol account for the vast majority of dietary triggers for diabetes)  Get rid of those foods and you are a long way to conquering diabetes.
  • Fitness:  Latest research in fitness and human health suggests we are aerobic creatures.  We were meant to move miles daily.  Inactivity fuels the sluggish metabolism that causes diabetes.  The more muscles you build typically the better diabetic control you will have.  You should be prepared to discuss fitness routines at each diabetic office visit.

4)Physical exams

  • Yearly Retinal Exams:  Small vessels in the back of the eyes are very susceptible to damage from diabetes.  Even if you vision seems “Good” yearly screenings are imperative.  Damage can occur without obvious symptoms….initially.  Diligence pays off for saving eyesight.
  • Foot Exams:  Annual examinations are recommended to check nerve conduction and assess for areas of concern.  Diabetics often develop neuropathy (painful or deteriorating sensation) in their feet.  Remember to take your shoes off for the doctor when starting your routine diabetic exams.
  • Blood Pressure Monitor:  Diabetics with High blood pressure are at higher risk of heart attack, stroke, and kidney disease.  Our goal would be to keep your bp below 120/80 or less.

5)Medication Adherence 

Medications do not prevent diabetes.  Medications do not necessarily save someone from the disease of diabetes.  Diet and lifestyle choices play the biggest role in actual treatment.  That said, in some instances medications are used.  If offered medications for blood pressure or blood sugar, one should consider this a serious step and take as routinely as possible.  Report side effects to your doctor and continue to strive for necessary lifestyle modifications.  Medications can be removed!

I hope you will look forward to the next post on Diabetes….on Diabetic Remission

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