Type 2 Diabetes: Living With Complications

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You need to have routine exams and tests to monitor the progress of your complication from type 2 diabetes and to screen for other complications that may develop.

Schedule of exams and tests for diabetes complications
Complication Tests if you do not have the complication5 Tests if you have the complication

Eye disease (diabetic retinopathy)

Every year, have:

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 of the back of your eyes (fundus photography) taken, to monitor diabetic retinopathy and evaluate the effectiveness of your treatment.
  • Fluorescein angiogram, to check for and locate any tiny leaking blood vessels in the retina.

Kidney disease (diabetic nephropathy)

Every year, have one of the following:

As needed to monitor your condition, have:

  • A spot urine or 24-hour urine test, to check the total amount of protein leaking from your kidneys over 24 hours.
  • Blood electrolyte tests, to evaluate whether your kidneys are maintaining normal electrolyte balance.

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 to see whether it is rising. Your blood pressure should be less than 130/80 mm Hg.

Every 1 to 2 years or more often, if indicated, have a:

  • Cholesterol and triglyceride level test, to evaluate cholesterol levels in your blood. Your LDL cholesterol level needs to be less than 100 mg/dL or aim for keeping it at 70 mg/dL. Your triglyceride level needs to be less than 150 mg/dL. And, if possible, your HDL cholesterol level needs to be more than 40 mg/dL for men and more than 50 mg/dL for women.

As indicated, have:

As indicated, have:

For more information on tests, 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 for your response to light touch, pressure, temperature, and vibration, particularly in your feet and legs. Simple tests can be used to screen for loss of sensation. These tests should be done on both feet.
    • Touching the end of your toe with a thin plastic fiber (monofilament test) can assess your sense of light touch or pressure.
    • A cold metal tuning fork may be held to your leg to evaluate your sensation of temperature.
    • A vibrating tuning fork may be touched to your foot to assess your sensation of vibration.
  • Test of muscle strength and reflexes, especially those in your ankles and knees.
  • Careful examination of your feet for infections, injuries, or bone and joint problems. A complete exam of your feet should be done at least once a year.
  • Blood pressure and pulse check when lying down, sitting, and standing.

As indicated, have:

  • Electromyogram (EMG), to measure how well and how quickly particular nerves and muscles are working.
  • Nerve conduction studies, to test how well specific nerves conduct electrical impulses.

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

  • Ultrasound of the bladder, X-ray of the entire urinary system (intravenous pyelogram), or a cystometrogram (which measures bladder storage capacity), if you have a problem with bladder control.
  • Gastric emptying study to evaluate the speed at which your stomach empties. Nerve damage from diabetes (gastroparesis) can slow this rate.

Since persistent high blood sugar levels are directly related to complications from diabetes, have a hemoglobin A1c test every 3 to 6 months to monitor your blood sugar control.

More information

By: Healthwise StaffLast Revised: May 14, 2010
Medical Review: Caroline S. Rhoads, MD - Internal Medicine
Matthew I. Kim, MD - Endocrinology

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