The Importance of Comprehensive Diabetes Checkups

If you have diabetes, you know you need to monitor your blood glucose levels, take insulin, and make the right diet and exercise choices to stay healthy. And you also know that you need regular diabetes checkups so your healthcare team can help you manage your diabetes.

But there are other factors you need to consider.

Having diabetes can increase your risk for a few other serious health conditions. That makes comprehensive health checkups crucial to living a full, healthy life with diabetes.

Here are some of the things your care team should be exploring during your checkups:

Diabetes and Your … Cardiovascular Health

Diabetes means you need to pay extra attention to your heart. Because high blood sugar can damage your blood vessels over time, the disease can increase your chances of cardiovascular problems, including:

• Heart attack
• Stroke
• The hardening of your arteries (atherosclerosis)

Research shows that people with diabetes are up to five times more likely to develop heart disease compared to those without diabetes. That's why your doctor should keep a close watch on your heart. They might recommend lifestyle changes, medications, or both to help protect it.

Diabetes and Your … Nervous System

Another common disease that often accompanies diabetes is diabetic neuropathy. This form of nerve damage is often due to high blood sugar levels and occurs in about half of diabetes patients.

This condition can affect various parts of the body, including the legs, feet, arms, and hands, leading to symptoms such as tingling, numbness, pain, and muscle weakness. It's more common in those who have had diabetes for many years. Types include:

• Peripheral Neuropathy: This is the most common form of diabetic neuropathy and affects the feet and legs first, followed by the hands and arms. Symptoms can include numbness, tingling, pain, or weakness in the affected areas. Peripheral neuropathy can lead to foot problems like ulcers and infections due to decreased sensation.
• Autonomic Neuropathy: This type affects the nerves that control the heart, regulate blood pressure, and manage blood glucose levels. It can also affect other internal organs, leading to problems with digestion, respiratory function, and urinary tract function. Symptoms vary based on the organ affected and can include abnormal heart rate, digestive issues, bladder dysfunction, and sexual dysfunction.
• Focal Neuropathy: This type involves damage to single nerves, often in the hand, head, torso, or leg, and can cause sudden weakness or pain. It's sometimes called mononeuropathy. Common examples include carpal tunnel syndrome and “diabetic amyotrophy,” which affects nerves leading to the thigh muscles.
• Proximal Neuropathy: Also known as diabetic amyotrophy, this type starts with pain in the thighs, hips, or buttocks and can lead to weakness in the legs. It typically affects one side of the body and is more common in older adults with diabetes.

Luckily, diabetic neuropathy can be prevented with blood sugar control, healthy eating, regular exercise, and avoiding smoking and excessive alcohol consumption. Your doctor should test you regularly for signs of diabetic neuropathy.

Diabetes and Your … Kidney Health

Over time, diabetic neuropathy can lead to kidney damage. Diabetes that isn't well-managed can harm the blood vessels and filters in the kidneys, impairing their ability to remove waste from the blood efficiently. Over time, this can progress to kidney failure, which can be fatal without dialysis or a kidney transplant. Kidney disease can also double your risk of cardiovascular disease, so regular screenings for kidney disease are essential for people with diabetes.

Managing kidney disease early can keep it from progressing to kidney failure. Your doctors may use tests like serum creatinine for glomerular filtration rate (GFR) to assess kidney function and urine tests for albumin, indicating early kidney disease. Keeping blood glucose levels and blood pressure under control is key to preventing or slowing the progression of kidney disease.

Diabetes and Your … Dental Health

You might not automatically think of your teeth when you think of diabetes.

But diabetes can make dental problems — from gum disease to cavities — more likely.

Because diabetes can lower the amount of saliva in your mouth and increase sugar levels in your saliva, it creates a perfect storm for dental issues. In fact, nearly 22% of people with both Type I and Type II diabetes deal with periodontal disease, a serious gum condition.

This means keeping up with your dental health isn't just about avoiding cavities; it's a key part of managing your diabetes.

Going for regular dental checkups can help catch gum disease early on. Combined with at-home care like brushing and flossing, they can make a big difference in your overall health.

Diabetes and Your … Mental Health

Diabetes can also significantly impact mental health. People with diabetes are at double the risk for conditions like depression compared to those without the disease.

According to The National Institute of Mental Health, chronic conditions, including diabetes, can increase your risk of depression.

After all, diabetes isn’t a “hands-off” disease. It takes active blood sugar monitoring, healthy eating, and exercise alongside medication to stay healthy with diabetes. Having to be constantly vigilant can be emotionally exhausting.

And depression, in turn, can affect your physical health and your ability to manage your diabetes effectively.

So, if your doctor doesn’t ask about your mental health, bring it up. They might not be able to address mental health themselves, but they can point you to resources that can. Inquiring about your mental health can also shed light on some of the blood sugar numbers they’re seeing, so they can help you get them under control.

Diabetes and Your … Eye Health

Your eyes are also an area that requires special attention. Diabetes increases the risk for several eye conditions, like diabetic retinopathy (which damages the retina), macular edema, cataracts, and glaucoma. And damage to your retina can happen without any noticeable symptoms. You might not see any changes until the condition has advanced.

That's why getting your eyes checked regularly is so crucial.

• If you've got Type 1 diabetes, make a plan to visit an ophthalmologist — not just your regular eye doctor but a specialist — within the first five years of your diagnosis.
• For people with Type 2, the timeline speeds up. You should see an ophthalmologist within your first year of diagnosis.

Regardless of which type you have, you should go back to the ophthalmologist once a year. During these visits, your doctor will do a dilated eye exam to take a close look at your retina and other parts of your eyes. This exam is key, because catching any issues early can make a huge difference in preventing vision loss.

Diabetes and Your … Foot Health

Foot care is also extremely important when you have diabetes. People with diabetes are at higher risk of complications like foot ulcers, infections, and in some cases, the possibility of amputation. This risk is primarily caused by diabetic neuropathy, which affects your ability to feel pain or discomfort in your feet, and peripheral vascular disease, which can reduce blood flow to your feet.

It's recommended that people with diabetes inspect their feet daily for any changes or injuries they might not feel due to nerve damage. Because you may have reduced feeling in your feet, you should use a mirror to check the bottoms of your feet every day. Keep a close eye on any changes, such as discoloration, sores, cuts, or changes in skin texture. Even a minor injury, like stepping on a thumbtack without realizing it, can lead to serious complications if not treated promptly.

If you notice anything unusual, seeing a podiatrist or your primary care physician as soon as possible is key. During your regular diabetes checkups or visits to a primary care physician, your doctor should examine your feet. They should do this at least every three to six months to catch issues before they worsen.

And don’t forget about proper footwear. Well-fitting shoes that support and protect your feet can prevent injuries. Avoid open-toed shoes or flip-flops to reduce the risk of cuts or other injuries. Pedicures can pose a risk due to potential infections, so it's safer to seek foot care from a podiatrist who understands diabetes-related foot issues.

Diabetes and Your … Vaccinations

Another important ingredient for your overall health is regular vaccinations. The CDC recommends vaccinations against flu, pneumonia, hepatitis B, and other diseases for people with diabetes due to their increased risk of severe complications from these infections. Because diabetes can weaken the immune system, keeping up with your vaccinations can prevent illnesses that could lead to hospitalization or even death. These include:

• The flu vaccine
• The pneumococcal vaccine
• The hepatitis B vaccine, particularly for adults under 60 years with diabetes

Discuss vaccinations at your regular diabetes checkups to ensure that you’re getting the vaccines you need to maintain health and prevent disease complications.

Hepatic Health and Diabetes

People with diabetes are also at risk of developing non-alcoholic fatty liver disease (NAFLD), now also known as metabolic dysfunction-associated steatotic liver disease (MASLD). This condition manifests when excess fat accumulates in the liver not due to alcohol consumption. NAFLD affects about one-quarter of the population in the United States. And shockingly, it’s also become the biggest liver-related concern among children, with its rate doubling among kids in the past 20 years.

It’s important to prevent fatty liver because it can progress to inflammation known as non-alcoholic steatohepatitis (NASH), which may eventually lead to significant liver damage, including cirrhosis — a state where the liver is largely replaced by scar tissue.

The biggest challenge with liver disease is its silent progression. You will probably have no symptoms until the condition has advanced significantly. That makes it even more important for you and your healthcare team to monitor your liver health. Regular screenings, including blood tests and ultrasounds, can play a vital role in early detection, allowing for timely intervention.

Luckily, preventative measures for liver diseases look a lot like the steps you already take to manage your diabetes: losing excess weight, eating a balanced diet, engaging in regular physical activity, and minimizing alcohol intake. So, if you’re effectively managing your diabetes, you’re also reducing your risk of liver disease.

Staying Healthy Requires a Diabetes Checkup … and So Much More!

Managing diabetes is about much more than just keeping tabs on blood sugar levels. From your heart to your nerves, and from your kidneys to your gums, diabetes can affect almost every part of your body. But with comprehensive diabetes checkups that examine your health from head to toe (and everywhere in between!), you can still live a full and healthy life.

And because managing your blood sugar is a critical part of preventing many of these diseases, a continuous glucose monitor (CGM) can make staying healthy easier than ever. And our CGM guide walks you through the options so you can choose one that works for you.

Ready to get your CGM? We can help!