November 19, 2016
Question from Yankton, South Dakota, USA:
My son was diagnosed two years ago. Is there any routine laboratory work that should be done, even yearly? We see the endocrinologist every 3 months and have an A1c completed, but have never had anything further. He also has a physical yearly and our primary care physician has never ordered laboratory work either.
Most guidelines, including those of the American Diabetes Association (ADA), the Pediatric Endocrine Society (PES), and the International Society for Pediatric and Adolescent Diabetes (ISPAD) include not only periodic A1c testing but also lipid, thyroid functions, kidney functions, and celiac disease assessment. Canadian, Australian and European societies have similar guidelines.
You may want to discuss with your diabetes team why these are or are not being checked. Our own practice has been to do such testing yearly, more frequently if abnormal. We have also been checking vitamin D levels and periodic bone density DXA (dual-energy X-ray absorptiometry) scans since we find so many abnormalities so commonly and the low vitamin D levels may have implications for diabetes related complications such as cardiovascular, blood pressure and lipid problems, as well as other autoimmune problems like thyroid and celiac disease.