Type 2 diabetes: follow-up

0


Type 2 diabetes: and after the diagnosis?

Diabetes is characterized by too much sugar in the blood (hyperglycemia), which can lead to problems with the cardiovascular system, eyes, kidneys, nervous system and feet. If the doctor diagnoses you with diabetes, they will talk to you carefully to see how affected your body is by the disease.

Discussion
  • The doctor checks if you are leading a healthy lifestyle: Are you getting enough exercise? Do you drink alcohol and, if so, how much? Are you eating fat? Do you tend to salt your food a lot? Do you smoke ?
  • Do you have symptoms that suggest cardiovascular disease? Do you have sexual problems?
  • Are there cases of diabetes,hypertension or cardiovascular disease in your family?
Physical examination
  • Your weight and height are measured to determine if you are overweight.
  • Your blood pressure is taken.
  • The arteries in your legs and feet are checked to see if you have good blood circulation.
  • Your feet are examined to see if they have an abnormal position, sores or calluses.
  • The sensitivity of the soles of the feet is also controlled.
Additional tests

Treatment of risk factors for cardiovascular disease

Treatment for type 2 diabetes is important to prevent damage to the body’s blood vessels from developing. Good diabetes treatment is not just about treating high blood sugar. A high blood pressure (hypertension), a abnormal cholesterol and fat levels must also be treated. Indeed, all these elements contribute to an increase in cardiovascular risk.

Treatment of hypertension

For every 100 people with type 2 diabetes, 40 to 60 already have high blood pressure by the time diabetes is diagnosed. The ideal mean arterial pressure does not exceed 130/85 mmHg.

You can lower your blood pressure by making lifestyle changes: lose weight if necessary, eat less salt, exercise enough, limit your alcohol intake, and quit smoking.

If these measures do not work enough, your doctor will decide to prescribe antihypertensive medication. Sometimes a single drug is not enough to achieve a sufficient reduction in blood pressure and it is necessary to combine several drugs. The choice of medication depends on your other symptoms and illnesses.

Treatment of abnormal cholesterol and fat levels

Regardless of the cholesterol levels in the blood, a cholesterol lowering agent (statin) is started in all people with type 2 diabetes who:

  • already have heart and / or vascular disease;
  • are over 40 years of age and have an additional risk factor (e.g. smoking, family history, high blood pressure, high levels of fat in the blood);
  • and possibly also, who are under the age of 40 and have a level of ‘bad’ cholesterol (LDL) greater than 100 mg / dl.

At the same time, weight loss, adopting a low-fat diet, practicing sufficient physical activity and stopping smoking remain important in the fight against excess cholesterol and fat in the body. blood.

Good control of blood sugar (blood sugar) levels will also reduce the amount of fat (triglycerides) in the blood. On the other hand, good blood sugar control has no influence on cholesterol.

Follow-up of people with type 2 diabetes

You can define, in consultation with your doctor, the frequency of your follow-up consultations. In most cases, these consultations take place every three months. For a good follow-up of diabetes, it is essential to maintain good long-term relationships with the general practitioner, the diabetologist (diabetes specialist) and any other healthcare providers. Good follow-up has been shown to reduce the number of complications.

What exams are performed during a routine check-up?

The doctor discusses the following topics:

  • He asks you if you have had hypoglycaemia (see the patient guide ” Diabetes: hypoglycemia (too little sugar in the blood) “;
  • He asks you about the presence of symptoms that may suggest damage to the blood vessels;
  • He goes through your medication regimen and adapts it if necessary;
  • It encourages you to adopt and maintain a healthy lifestyle.

He will carry out or possibly plan the following examinations:

  • Weight and blood pressure control;
  • A foot exam if you have sores, sensory disturbances or calluses. A foot examination will always be done, including if you have known abnormalities in the position of the feet, if you have poor blood circulation in the feet or if you have had an amputation in the past;
  • A blood test to check the level of glycated hemoglobin (HbA1c), to assess the kidney function and measuring fat or cholesterol levels ;
  • A urine analysis to detect a possible protein loss (kidney damage);
  • An examination at the ophthalmologist to check the blood vessels in the eyes;
  • A review of the injection sites in the event of a insulin treatment.
And if there is a loss of protein in urine ?

Hyperglycemia can damage the kidneys. This is why the doctor will check your urine regularly for protein. It may indeed be a sign indicating the onset of kidney damage. Often one can observe at the same time a damage to the small blood vessels in the eyes.

When a loss of protein is detected in the urine, tighter blood pressure control is required. This control is ensured by taking antihypertensive drugs and adopting a low-salt diet. It is also very important to stop smoking, to properly control the level of sugar in the blood (glycemia) and to treat excess cholesterol and fat to avoid worsening kidney damage.

The doctor will not just look for the protein in urine, he will also monitor the kidney function by means of blood tests. If the loss of protein in the urine is too great or if the blood test shows that kidney function is deteriorating quickly, you will be referred to a nephrologist (kidney specialist) for further treatment.

What can you do to manage your diabetes?

Watch your weight. Try to lose your extra pounds. Get enough exercise and try to quit smoking!

You can check your blood sugar yourself using a small drop of blood taken from your fingertip. If your diabetes is being treated with insulin injections, you can learn how to adjust your insulin dose based on your measured sugar levels. If you are not using insulin but are taking hypoglycemic drugs, self-measurements can be useful to check if you are hypoglycemic.

If you are not on medication to lower blood sugar, but are only on a diet, self-measurements can help you understand the factors that regulate your blood sugar levels on a daily basis.

Want to know more?

Are you looking for more specialized help?

Sources