The symptoms of type 2 diabetes are caused by high levels of sugar (glucose) in your blood. The best way to control these symptoms and limit complications is to take good care of yourself, including checking your blood sugar regularly and following your medical team’s plan for diabetes exams.
"Controlling the symptoms of type 2 diabetes is all about education and management,” says Dinamarie C. Garcia-Banigan, MD, MPH, an endocrinologist and diabetes specialist at the Lahey Clinic in Burlington, Mass. “People with type 2 diabetes need to make blood sugar management part of their daily lifestyle."
Although many people with type 2 diabetes need medications to control their symptoms, most experts agree that the most important parts of type 2 diabetes treatment are a healthy diet, regular exercise, and good management skills. That includes staying on top of your blood sugar testing and all of your diabetes exams.
Number One on Your Checklist: Check Blood Sugar
Blood sugar testing is used to diagnose diabetes, but it’s also part of ongoing care. "I can't emphasize enough how important it is that people with type 2 diabetes learn how to keep track of their blood sugar," Dr. Garcia-Banigan says. While some diabetes testing can be done on your own, you’ll need to see your doctor for additional office tests. These blood sugar tests should be part of your diabetes management:
Self-testing. The ability to monitor your own blood sugar with a finger stick and a glucose monitor (glucometer) tells you and your doctor how well your diabetes management is working during your average day. "Most people with type 2 diabetes need to test their blood glucose at least once a day, and this is usually done in the morning before breakfast,” Garcia-Banigan explains. “A fasting morning blood sugar should be in the range of 90 to 110." If you’re taking insulin or your glucose isn’t well controlled, your doctor may recommend a more frequent testing schedule.
Glycosulated hemoglobin test (HbA1c) blood test. "This blood test, combined with the log from your daily self-testing, gives a good picture of how well your diabetes has been controlled over the past three months," Garcia-Banigan says. Some people whose symptoms are well controlled may only need to do this test every six months.
Other blood sugar tests. When you’re first diagnosed with type 2 diabetes or at times when your treatment is being re-evaluated, your doctor may order a fasting blood glucose test or an oral glucose tolerance test.
Other Important Type 2 Diabetes Testing
Along with checking your blood sugar, it’s important to keep up with other routine diabetes tests:
Urine testing. "It’s important to look for signs of protein in the urine. If your urine protein number is more than 30, it means you need to control your blood pressure and blood sugar better. People with type 2 diabetes should have this type of urine testing done at least once a year," Garcia-Banigan says.
Blood lipid testing. Because type 2 diabetes increases the risk of heart disease, you need to have your blood lipids (fats) tested at least once a year. It’s important to check both cholesterol and triglyceride levels. "People with type 2 diabetes and known heart disease may need to be checked more often,” Garcia-Banigan says. “You want your LDL to be below 70 and your triglyceride level to be below 150."
Blood pressure testing. Both type 2 diabetes and high blood pressure increase your risk of stroke and heart disease. Your blood pressure should be checked at every exam. "You should aim for a systolic blood pressure below 130 and a diastolic blood pressure below 80," Garcia-Banigan advises.
Type 2 Diabetes Exams to Schedule
In addition to regular doctor exams, you also need to keep current with these specialists:
Diabetes caregiver. "Most people with type 2 diabetes should have a visit with their diabetes specialist at least once every three months,” Garcia-Banigan says. “Some of these visits can be with a nurse practitioner or a certified diabetic educator (CDE) in the office. It's all about diabetes education.
Dental exams. One symptom of type 2 diabetes is difficulty fighting off infections, such as gum disease. That's why you should see your dentist and dental hygienist every six months. "Your mouth is a high-bacteria area, and healthy teeth and gums are your natural barrier between these germs and your bloodstream," Garcia-Banigan notes.
Eye exams. Visual disturbances caused by cataracts or glaucoma are common in people with type 2 diabetes. The retina can also be damaged due to complications of diabetes. "It’s important to see an eye specialist and have a dilated eye exam once a year, or more frequently if your eye doctor recommends it," Garcia-Banigan says.
Nutrition counseling. "Understanding nutrition is an essential part of managing type 2 diabetes,” Garcia-Banigan explains. “In most cases, it starts with losing 5 to 10 percent of your body weight." A dietitian or diabetes nutrition expert can help you learn to count carbohydrates and time your meals properly. Diet and nutrition counseling should be done during all of your routine office visits, and more frequently if necessary.
"Depression and sleep apnea are other problems that may be more common in people with type 2 diabetes, so watching for signs and symptoms of these conditions should also be on your checklist," Garcia-Banigan adds.
Your diabetes testing and exams are very important, but nothing is more important than educating yourself about type 2 diabetes and taking an active role in your diabetes management. Ask your diabetes caregivers to help you create a personal checklist, and make managing your diabetes well part of your lifestyle by keeping that checklist up to date.