According to the recommendations of the "China Type 2 Diabetes Prevention and Treatment Guidelines", diabetic patients should undergo regular physical examinations. What items should be checked?
1.Height, weight, BMI
Monitoring of height, weight and BMI can not only indicate the risk of overweight and obesity, but also guide the medication of diabetic patients. For example, doctors will refer to BMI levels when prescribing medicines for patients with type 2 diabetes and choose from different types of medicines such as metformin, insulin, insulin secretagogues, and alpha-glucosidase inhibitors.
2. Fasting/postprandial blood glucose/HbA1c
Blood glucose monitoring is one of the "five carriages" of diabetes prevention and treatment. If conditions permit, every diabetic patient should be equipped with a blood glucose meter to conduct regular self-monitoring at home. HbA1c can truly reflect the average level of blood sugar control in diabetic patients over the past three months and has important reference significance for treatment.
However, some patients have large blood sugar fluctuations, and it is difficult for HbA1c to truly reflect this fluctuation. Therefore, HbA1c needs to be compared with the usual blood sugar monitoring results for mutual reference.
3. Blood pressure
Many elderly patients with diabetes have high blood pressure. For these people, if possible, they should be equipped with a certified upper-arm electronic blood pressure monitor for correct self-monitoring at home.
4. Urine routine
The most important examination items related to diabetes in urine routine mainly include urine sugar, urine ketone bodies, urine protein, red and white blood cells, etc. Among them, urine protein examination is an important basis for diagnosing diabetic nephropathy and is also an important basis for doctors to clinically stage diabetic nephropathy. When the protein content in urine exceeds 0.15g/24h, it is called proteinuria, and the urine routine may be qualitatively positive. Routine urine test results are greatly affected by other factors, so they should be reviewed at least every quarter.
5.Total cholesterol/high and low density lipoprotein/triglycerides
Diabetic patients who are overweight are particularly concerned about these indicators. The higher the detected values of cholesterol, low-density lipoprotein and triglycerides, the more serious the blood lipid disorder and the greater the risk of cardiovascular disease. Different from urine routine, blood lipid testing can be done once or twice a year, and repeated testing is not required.
6. Creatinine
Abnormal increases in serum creatinine usually indicate the worsening of diabetic nephropathy. Serum creatinine can also be used to evaluate the progression of diabetic nephropathy. Combining uric acid and urea nitrogen levels, we can also assess the current level of kidney function in diabetic patients. Many diabetic patients who take hypoglycemic drugs metabolized by the kidneys are very concerned about their kidney function, which has special guiding significance for them. Like blood lipid testing, blood creatinine only needs to be tested once a year.
7. Liver function
Like kidney function tests, diabetic patients who take medications all year round are also very concerned about their liver function. In fact, as long as there are no problems with your liver and kidney functions, and you follow the doctor's plan and take anti-diabetic drugs regularly, the impact on your liver and kidney functions will be very small, and diabetic patients don't need to worry. Liver function testing is also done once a year.
Another important purpose of checking liver function is to understand whether the patient has fatty liver. The detection rate of fatty liver is higher in patients with type 2 diabetes. For diabetic patients with fatty liver, they should pay more attention to correcting blood lipid disorders and choosing appropriate anti-diabetic drugs. They should also emphasize diet, exercise and weight control.
8. Electrocardiogram
If your heart health has been good in the past and there are no chronic diseases such as high blood pressure or blood lipid disorders, you can have an electrocardiogram every year.
9. Vision and fundus
Compared with ordinary people, elderly patients with diabetes are more likely to develop cataracts, glaucoma, fundus hemorrhage and other eye problems, so annual eye examinations are very necessary. Many diabetic patients do not discover the symptoms of fundus bleeding in time and take anticoagulant drugs such as aspirin without authorization, which aggravates the bleeding symptoms. This is very inappropriate.
10.Dorsalis pedis artery pulsation and neuropathy
Because of abnormal sensation, many diabetic patients fail to detect and treat small wounds in time, which is very likely to cause infection and may lead to amputation, so relevant preventive examinations are very necessary. Examination of the dorsalis pedis artery pulse and neuropathy should be performed at least quarterly.
Diabetic patients should also conduct active self-examination at home. If they find that they feel abnormal or have wounds on their body, they should deal with them promptly. Other examination items need to be determined according to the condition!
