Routine for managing diabetes

Diabetes is a chronic disease and unfortunately has no quick fix.

Instead, the effective management of diabetes requires a healthy diet, regular exercise, doctor visits and blood and urine tests.

This to-do list is a guide to the types of tests you should be having as a diabetic. Neglecting these tests increases your risk of allowing diabetes to harm other parts of your body, such as your heart, brain, kidneys, eyes and limbs.


Haemoglobin A1c or HbA1c is a blood test that should be done every three to four months.

As a diabetic, you should be monitoring your blood sugar levels daily at home using a blood glucose monitor. Daily monitoring of your blood sugar allows you to understand the effect of various foods and exercise on your body.

In addition to this daily monitoring, another useful test is the haemoglobin A1c blood test, which should be done every three to four months. This test gives your doctor an average of your blood sugar levels over the last few months and allows the doctor to effectively manage your medication regime.

The target result for this test is a value less than 7 per cent.


A cholesterol test is a blood test that should be done yearly.

Diabetes increases your risk of a heart attack or a stroke due to cholesterol buildup in your blood vessels. Your doctor will be able to get a better understanding of how diabetes is affecting your cardiovascular system by measuring your cholesterol levels via a simple blood test.

In addition, you should have your blood pressure checked regularly to screen for hypertension (elevated blood pressure), which can also lead to heart attacks, strokes and kidney disease.

Urine microalbumin

A urine microalbumin test should be done annually. This test checks for diabetes-related kidney disease or diabetic nephropathy.

This test will check if there is protein in your urine which is a sign of damage to your kidneys.

Foot exam

A foot exam should be done yearly.

Diabetes can lead to nerve damage or diabetic neuropathy because of high blood sugar levels. This can cause numbness in your limbs, making you less aware of pain and damage to your feet.

A regular foot exam with your doctor is necessary to make sure that you do not have decreased sensation in your feet which could lead to foot ulcers and possibly the need for amputation.

A daily foot exam should also be done at home to check for damage to your skin.

Eye exam

A dilated eye exam should be done every one or two years.

High blood sugar can cause diabetic retinopathy, or damage to the blood vessels at the back of your eye, and can lead to loss of vision. It is essential that you get this exam done yearly if you have diabetic retinopathy, or every two years if you have diabetes without retinopathy.

Your doctor will dilate your pupils to ensure the retina is fully examined.

These tests are important for monitoring your diabetes and to minimise damage to other parts of your body. However, please remember that as a diabetic, it is essential that you take control of the disease by checking your blood sugar, taking medication as prescribed, following an appropriate diet and exercising regularly.

Dr. Diane Hislop-Chestnut is board-certified in endocrinology, diabetes and metabolism and is based in Grand Cayman.