***Managing Diabetes - Cholesterol Testing

Your doctor should check your cholesterol at regular intervals, at least once a year.  High levels of cholesterol in the blood can damage your heart, major blood pathways, and the delicate blood vessels of the eyes and kidneys.  Use these numbers to stay in check.

Total Cholesterol:

 The US government’s National Cholesterol Education Program recommends that total cholesterol should below 200 milligrams per deciliter (mg/dL) (5.2 millimoles per liter  [mmol /L]). You should aim for a considerable lower goal. Large population studies have shown that the lower your cholesterol, the lower your risk of heart problems, until you reach a threshold of about 150 mg/dL (3.9 mmol/L. Use this number as your target and not the upper limit.

Low-density lipoprotein cholesterol:

LDL cholesterol is often called “bad” cholesterol because it raises your risk of heart problems and other blood vessels complications.  According to the US government, your LDL should be below 100 mg/dL,  (2.6 mmol/dL if you have diabetes. But many scientists are pushing for stricter standards, including, reductions below 70 mg/dL  (1.8 mmol/L) for high-risk patients. Some researchers recommend lowering your LDL by 30 to 40 percent regardless of what your starting level is.  Your risk of heart disease problems drops as LDL decreases, until you reach a level of approximately 40 mg/dL

(1.0 mmol/L).

High – density lipoprotein:

HDL cholesterol is often called (good: cholesterol because it carries cholesterol out of   the body. The higher your HDL, the better. Current recommendations are to have an HDL level above 45 mg/dL, (1.2 mmol/L) for men and above 55 mg/dL (1.4 mmol/L) for women.

Some doctors may interpret HDL in the context of your total cholesterol concentration: in that context, a favorable HDL reading would be at least one third of your total cholesterol. For example, if your total cholesterol is 150, a healthy HDL would be 50 or above. This is important, as many people who follow healthful diets do not have any kind of cholesterol concern.

Triglycerides:

Triglycerides are tiny fat particles transported in the bloodstream. Normal triglyceride concentration is less than 150 mg/dL (3.9 mmol /L). Keeping below this number can help prevent heart disease.

OTHER TESTS TO HAVE

Three common tests to ask your doctor for that are important:

Complete blood Count (CBC):

This test reflects the state of your blood cells. Many people with Diabetes develop anemia, meaning they have fewer red blood cells than they should. A CBC lets your doctor easily check this. If your blood count is low, your doctor will find the reasons for it, which could include kidney disease, iron deficiency, and use of certain medication, abnormal bleeding, or other factors.

Chemistry Panel:

A chemistry panel is routine and assesses your overall health, with a special focus on your kidneys and liver. This test lets doctors check for potential adverse effects caused by medication. Don’t be too alarmed if your laboratory values are not where they should be.
Just take action. Take control of your diet and work with your health professional to   work out strategies on ways to effectively taking control to manage your health regimen.

BLOOD PRESSURE:

Maintaining healthy blood pressure is extremely important. Increased pressure inside your arteries can damage the arteries themselves, as well as your heart, eyes, kidneys, and nerves. The longer your blood pressure stays high, the more damage it can do.
Problems can reverse and travel in the opposite direction, too. Damage to the kidneys can lead to high blood pressure. The reason being, your kidneys play an important role in regulating your blood pressure.  If diabetes affects the kidney’s function, they lose some of the ability to control blood pressure and other functions. Here are the targets to aim for.

Normal blood pressure is less than 120/80 millimeters of mercury (m Hg). Most doctors want to keep the blood pressure of people with diabetes under 130/80. If you have kidney-related problems or any other complications, the goal will be stricter, typically 125/75 mm Hg.

Have your blood pressure checked regularly. If it is not at the level where it should be, take a look at your diet or your exercise program. Speak with your doctor about what additional treatments can be done.

OVERALL TOTAL BODY CHECK:

Diabetes affects your whole body. It is important to get the entire systems of your body checked for concerns or complications. Pay attention to these special parts of your body.

Kidneys:

Your kidneys can easily be affected by diabetes, and usually your doctor will check your kidneys health with a simple urine test at least once a year the goal is to see whether your kidneys are losing protein—specifically a protein molecule called albumin. Albumin in itself is not very important. However, if it shows up in your urine, it indicates that your kidneys have been affected by diabetes and are not holding on to albumin, as they should. Albumin losses of greater than 30 milligrams over 24 hours are considered abnormal.

Another test that your doctor will check is the creatinine in your blood. This tests estimates the glomerular filtrate rate. You don’t have to be concerned understanding these tests, as your doctor will interpret the results of these tests for you.

Eyes:

Get your eyes checked at least once a year; you should schedule an eye examination with your ophthalmologist to check for any sign of retinopathy. These changes cannot be detected by an ordinary eye examination with a doctor’s opthalmoscope or during an optometric examination for eyeglasses. You should be sure to see an eye specialist if you
Have any changes in your vision.

If you smoke you should tell your eye doctor. Of course you will get a lecture but this is the time to listen and decide to quit smoking.

Feet:

Foot problems are common with diabetes. If your blood glucose has been poorly controlled, you are at risk of developing neuropathy. With neuropathy, comes nerve damage, you may not be aware of small injuries to your feet. Wound healing may be slowed as well. Small injuries can gradually worsen and become infected. This is the reason you need to have your doctor check your feet at least once a year.  The examination will include a check for sensation using a thin plastic thread, a check of your vibratory sense with a tuning fork and a thorough check for any signs of damages to our skin. A nurse who works at the George Washington Hospital recommends that you take off your shoes and socks each time you visit the doctor to be sure your doctor does not forget to examine your fee.

Timetable For Test

This is scheduled by your doctor

• Blood pressure
• Blood glucose levels
• CBC
• Chemistry panel
• Complete foot check (look for blisters, injuries, cuts, blisters, etc.)

Every 12 months

Cholesterol levels (total, HDL, LDL and triglycerides)
Eye exam by an ophthalmologist (to check for retinopathy)
Kidney test (albumin, creatinine, and glomerular filtration

Every 3-6 months

Hemoglobin A1c

At each doctors visit

Blood pressure
Foot exam (visual)