I have had mild diabetes for five years. For the past two years, especially in the past 10 months, it has been harder to control. Other than an A1c and a lipid check, what tests should I have to see what damage my body has suffered?

Health risk is definitely increased with diabetes. It has been shown in Americans that patients with diabetes are as likely to have a heart attack as it is for a person who does not have diabetes and who has already had a heart attack. Managing diabetes is also about managing risk factors. Your doctor should address blood sugar control, weight loss, lipid improvement, blood pressure, and other cardiac risk reduction practices. These are all done at the same time. The outcomes associated with eye complications, kidney complications, and nerve complications are associated with the A1c laboratory test with better results seen in patients with the best hemoglobin A1c. Your doctor should be doing routine screening to determine the presence of large blood vessel abnormalities (heart attack, stroke) and small blood vessel abnormalities (nerve, kidney, and eye). Such screening includes checking your blood pressure, checking the urine albumin, examining your feet, performing heart screening with a stress test, and a doing dilated eye exam.

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