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Screening crucial to care for diabetics
La Plata Health Watch
Dr. Matthew A. Clark
One of the most important challenges of providing good medical care for patients with diabetes is keeping up with the many important screenings recommended as part of routine diabetes care.
Diabetes mellitus is one of the most common chronic diseases of our Western culture. Type 2 diabetes, which primarily affects adults, is becoming more common as a result of the epidemic of obesity.
The disease is characterized by abnormally elevated blood-sugar levels. Over time, these elevated blood sugars can cause damage to many of the body's tissues and organs.
In addition to the prevention of type 2 diabetes through lifestyle modifications such as weight loss, regular exercise and proper diet, control of the disease and careful monitoring are necessary to reduce the risk of complications.
Diabetic screenings are divided among those performed regularly at each visit to the doctor and those that must be performed yearly.
At each visit, diabetic patients should have their blood pressure checked. Elevated blood pressure in diabetics significantly increases the risk of cardiovascular and kidney disease. Through routine blood-pressure screening and control, these risks can be greatly reduced.
Diabetics' feet also should be examined regularly. Diabetic complications which adversely affect the circulation and sensation in the feet can increase the risk of skin ulcers and infections.
Yearly screenings for diabetics include kidney, cholesterol and eye screens.
Diabetes is the leading cause of acquired kidney disease and kidney failure in the United States. Yet advanced kidney disease often is the far end of a spectrum of diabetic kidney effects that begin with asymptomatic damage to the kidney filter. Yearly urine screening to check the integrity of the kidney filter by looking for tiny amounts of urine protein can help identify kidney effects early. This allows for early intervention to delay or prevent the progression of diabetic kidney disease.
Annual cholesterol testing can identify another high-risk condition leading to cardiovascular disease, namely high cholesterol. Diabetics particularly are prone to cholesterol problems. Through regular screening and identification of high cholesterol levels, dietary and medical intervention can reduce the risk of heart disease.
Diabetes is among the leading causes of acquired blindness in the developed world. The disease can cause harm to the eyes through a variety of mechanisms. High blood sugars can affect vision directly. However, the cumulative effects of elevated blood sugars over time can lead to ocular problems, including an undesirable proliferation of blood vessels in the retina and the formation of cataracts on the lens. Regular yearly diabetic eye exams can identify problems at an early stage and allow intervention to protect vision.
Routine diabetic medical care not only allows for testing and treatment geared toward the control of high blood sugars but also provides the opportunity for a variety of regular screenings which are essential to preventing diabetic complications.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Health Center in Towaoc.
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