Type 1 Diabetes: Living With Complications

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Because you have a complication from type 1 diabetes, you need to have regular exams and tests to monitor its progression and screen for new complications.

Schedule of exams and tests for diabetic complications

Complication

Tests if you do not have the complication

Tests if you have the complication

Eye disease (diabetic retinopathy)

Every year, have:5

If you are at low risk for vision problems, your doctor may consider follow-up exams every 2 to 3 years.

As often as indicated, have:

  • Pictures taken of the back of your eyes (fundus photography), to monitor diabetic retinopathy and evaluate your treatment.
  • Fluorescein angiogram, an imaging test, to find any leaking blood vessels in the retina.

Kidney disease (diabetic nephropathy)

Every year, have one of the following:5

As needed to check on your condition, have:

  • A 24-hour urine test to check the total amount of protein leaking from your kidneys. A result of 300 mg or greater of protein in 24 hours shows that the kidneys are leaking large amounts of protein (macroalbuminuria).5
  • Blood urea nitrogen (BUN) and creatinine levels, to help estimate how well your kidneys are removing wastes from the bloodstream.
  • Blood electrolyte tests, to check whether your kidneys are keeping normal levels of electrolytes (salts) in your blood.

If you develop kidney failure, you may need other tests. For more information, see the topic Chronic Kidney Disease.

Heart and blood vessel disease (macrovascular disease)

During every medical appointment, have:

  • Your blood pressure checked. Your blood pressure should be less than 130/80 mm Hg.6

At least every year, or more often, if indicated, have a:5

  • Cholesterol and triglyceride level test, to evaluate cholesterol levels in your bloodstream.
    • Your LDL goal is less than 100 mg/dL. Your LDL goal may be lower—less than 70 mg/dL—if you have heart disease.
    • If you are a man, your HDL goal is more than 40 mg/dL. If you are a woman, your HDL goal is more than 50 mg/dL.
    • You want your triglycerides to be lower than 150 mg/dL.

Have an:

  • Exercise electrocardiogram (treadmill EKG or cardiac stress test) if you have not been active and plan to begin a vigorous exercise program.

As indicated, have:

For more information, see the topics Heart Attack and Unstable Angina, Stroke, and Peripheral Arterial Disease of the Legs.

Nerve disease (diabetic neuropathy)

Periodically, have a:

  • Physical exam to check your response to light touch, pressure, temperature, and vibration, particularly in your feet and legs. Simple tests can screen for loss of sensation. Have these tests done on both feet.
    • Touching the end of your toe with a cotton wisp or a thin plastic fiber (called a monofilament test) assesses your sense of light touch or pressure.
    • A cold metal tuning fork held to your leg evaluates your sensation of temperature.
    • A vibrating tuning fork touched to your foot assesses your sensation of vibration.
  • Checkup on your muscle strength and reflexes, especially those in your ankles and knees.
  • Careful exam of your feet for corns, calluses, infections, injuries, or bone and joint problems. Have a complete exam of your feet at least once a year.7
  • Measurement of your blood pressure and pulse when lying down, sitting, and standing.

As indicated, have:

  • Electromyogram (EMG), to measure how well and how quickly particular nerves and muscles are working.

Tests for autonomic neuropathy (internal functioning) are specific to your symptoms, such as:

Other tests

Because persistent high blood sugar levels are directly related to getting diabetic complications, you need hemoglobin A1c and blood glucose tests at least 2 times a year to monitor your blood sugar control.

If your treatment is changing or if your blood sugar is not stable, your A1c may be checked every 3 months.

You may need a thyroid-stimulating hormone (TSH) test when type 1 diabetes is diagnosed and then every 1 to 2 years. This test checks for thyroid problems, which are common among people with diabetes.

By: Healthwise StaffLast Revised: November 2, 2010
Medical Review: John Pope, MD - Pediatrics
David C.W. Lau, MD, PhD, FRCPC - Endocrinology

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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