According to the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes, what items should be checked in the regular physical examination that diabetic patients should undergo?
1.Height, weight, BMI
The monitoring of height, weight and BMI can not only indicate the risk of overweight and obesity, but also guide the medication of diabetic patients. The patient’s medication. For example, when prescribing medication for patients with type 2 diabetes, doctors will refer to the level of BMI and choose among different types of medications such as metformin, insulin, insulin stimulants, and α-glucosidase inhibitors.
2. Fasting/postprandial glucose/HbA1c
HbA1c can truly reflect the average level of blood glucose control of diabetic patients in the past 3 months, which has important reference significance for treatment. However, some patients’ blood glucose is more volatile, and HbA1c can hardly reflect such fluctuation truly, so HbA1c needs to be compared with the usual blood glucose monitoring results for mutual reference.
3.Blood pressure
Many elderly diabetic patients are combined with high blood pressure. For these people, if they have the conditions, they should also be equipped with a certified upper-arm electronic blood pressure monitor for proper self-monitoring at home.
4.Urinary Routine
The most important tests related to diabetes are urine sugar, urine ketone bodies, urine protein and red and white blood cells. Among them, urine protein test is an important basis for the diagnosis of diabetic nephropathy, and also an important basis for the clinical staging of diabetic nephropathy by doctors. When the protein content in urine is as much as 0.15g/24h or more, it is called proteinuria, and the urine routine characterization may appear positive. The test result of urine routine is greatly affected by other factors, so it should be reviewed at least once a quarter.
5.Total cholesterol/high and low density lipoprotein/triglycerides
Patients with diabetes who are obese are particularly concerned about these indicators. The higher the value of total cholesterol, LDL and triglycerides, the more serious the degree of dyslipidemia and the greater the risk of cardiovascular disease. Unlike urine tests, lipid tests can be performed once or twice a year and do not need to be repeated.
6.Creatinine
An abnormal increase in blood creatinine usually indicates the degree of deterioration of diabetic nephropathy. Blood creatinine can also be used to assess the progress of diabetic nephropathy. Combined with the levels of uric acid and urea nitrogen, we can also assess the current level of kidney function in diabetic patients. Many diabetic patients taking glucose-lowering medications metabolized by the kidneys are very concerned about their kidney function, and this can be particularly instructive for them. As with lipid testing, blood creatinine only needs to be tested once a year.
7.Liver function
Like kidney function tests, diabetic patients who take medication all year round are also very concerned about their liver function. In fact, as long as their liver and kidney function is not a problem, in accordance with the program developed by the doctor, regular use of hypoglycemic drugs, the impact on liver and kidney function is very small, diabetic patients do not need to worry. Liver function tests are also required once a year.
Another important purpose of liver function tests is to find out whether the patient has a fatty liver in combination, and the detection rate of fatty liver is higher in patients with type 2 diabetes. For diabetic patients with combined fatty liver, it is more important to focus on correcting dyslipidemia and choosing appropriate glucose-lowering drugs, and to emphasize diet, exercise and weight control.
8.Electrocardiogram
If the heart is in good health and there is no combination of chronic diseases such as hypertension and dyslipidemia, an annual electrocardiogram is sufficient.
9.Vision and fundus of the eyes
Compared to the general population, older diabetics are more likely to have eye problems such as cataracts, glaucoma, and fundus bleeding, so an annual eye exam is essential. There are many diabetic patients who do not discover the symptoms of their fundus bleeding in time and take anticoagulant drugs such as aspirin without permission, which aggravates the bleeding symptoms, which is very undesirable.
10. Dorsal foot artery pulsation and neuropathy
Because of abnormal sensation, many diabetic patients fail to detect and treat small wounds in time, which is highly likely to become infected and then may develop into amputation, so relevant preventive examinations are very necessary. Dorsalis pedis artery pulsation and neuropathy should be checked at least once a quarter. Patients with diabetes should also perform active self-examinations at home to detect abnormal sensations or wounds that should be treated promptly.