From the Guidelines
For people with diabetes, regular health checks are essential to prevent complications, and the most recent and highest quality study 1 recommends that feet should be examined daily at home and professionally at least once a year, with more frequent checks if there are existing foot problems.
Key Recommendations
- Eye examinations should be done annually through a dilated eye exam to detect early signs of retinopathy.
- Kidney function should be tested annually with urine albumin and blood creatinine tests to monitor for diabetic nephropathy.
- Sensation testing (for neuropathy) should be performed at least annually using monofilament testing or other methods to check for loss of protective sensation. These regular screenings are crucial because diabetes can damage small blood vessels and nerves throughout the body, often without noticeable symptoms in early stages.
Importance of Early Detection
Early detection of complications allows for timely intervention, potentially preventing serious outcomes like foot ulcers, blindness, kidney failure, or severe neuropathy.
Individualized Care
People with additional risk factors or existing complications may need more frequent monitoring as determined by their healthcare provider, as suggested by 1 and 1.
Preventive Measures
Providing general preventive foot self-care education to all people with diabetes, including those with loss of protective sensation, on appropriate ways to examine their feet for daily surveillance of early foot problems, is also recommended by 1.
Multidisciplinary Approach
A multidisciplinary approach is recommended for individuals with foot ulcers and high-risk feet, as stated in 1 and 1.
Foot Care
Refer individuals who smoke and have a history of prior lower-extremity complications, loss of protective sensation, structural abnormalities, or peripheral arterial disease to foot care specialists for ongoing preventive care and lifelong surveillance, as recommended by 1 and 1.
From the Research
Checking Frequency for Diabetes Complications
The frequency of checking for diabetes complications such as foot, eyes, kidney, and sensations is crucial for early detection and management. Based on the available studies, here are some key points to consider:
- Kidney function: Studies suggest that kidney disease in type 2 diabetes mellitus (DM) is more heterogeneous than in type 1 DM 2. The estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio should be monitored regularly to assess kidney function 3, 4, 5, 6.
- Eye examination: Diabetic retinopathy is a common complication of diabetes, and regular eye examinations are essential to detect any changes in the retina 3, 5.
- Foot care: While there is no specific study mentioned in the provided evidence, it is generally recommended to check feet daily for any signs of injury or infection, and to have a comprehensive foot examination by a healthcare professional at least once a year.
- Sensations: Nerve conduction velocity and current perception threshold (CPT) can be used to detect sensory nerve damage at an early stage 4.
Recommended Checking Frequency
Based on the available studies, here are some recommended checking frequencies:
- Kidney function: eGFR and urine albumin creatinine ratio should be monitored at least once a year, or more frequently if there are any signs of kidney disease 6.
- Eye examination: Regular eye examinations should be performed at least once a year, or more frequently if there are any signs of diabetic retinopathy 3, 5.
- Foot care: Comprehensive foot examinations should be performed at least once a year, and daily self-examinations are recommended.
- Sensations: Nerve conduction velocity and CPT should be performed at least once a year, or more frequently if there are any signs of nerve damage 4.