From the Guidelines
Patients with diabetes should undergo annual comprehensive eye exams, annual urine tests for microalbuminuria, and regular monitoring of blood glucose levels and hemoglobin A1C every 3-6 months to detect and manage complications early. When it comes to screening tests for patients with diabetes, several key areas need to be addressed to prevent morbidity, mortality, and to improve quality of life.
- Annual comprehensive eye exams by an ophthalmologist or optometrist should begin for patients who have had T1DM for more than 5 years and for those with T2DM at diagnosis 1.
- Annual urine tests for microalbuminuria via urine albumin–creatinine ratio on a spot urine sample and eGFR should be performed in patients who have had T1DM for at least 5 years, in all patients with T2DM, and in all patients with comorbid hypertension 1.
- Regular monitoring of blood glucose levels and hemoglobin A1C every 3-6 months is crucial for maintaining optimal glycemic control and reducing the risk of microvascular and macrovascular complications 1. Additionally, patients with diabetes should undergo regular foot examinations to check for neuropathy and vascular complications, and blood pressure should be measured at every routine visit, with a target of less than 140/90 mmHg for most patients. A fasting lipid profile should be obtained at diagnosis and then annually, with LDL targets typically below 100 mg/dL. These screening tests are essential because diabetes affects multiple organ systems, and early detection of complications allows for timely intervention to prevent disease progression, ultimately improving quality of life and reducing mortality in patients with diabetes 1.
From the Research
Screening Tests for Patients with Diabetes
- Eye exams are an important screening tool for patients with diabetes to prevent severe and vision-threatening complications such as cataracts, glaucoma, and retinopathy 2
- Early detection and treatment of diabetic retinopathy can result in a significant decrease in vision loss 2
- Screening for diabetic nephropathy is also crucial, as it can lead to end-stage renal disease and increased mortality 3, 4
Recommended Screening Guidelines
- Fasting plasma glucose of 100 mg/dl or greater, random plasma glucose of 130 mg/dl or greater, or HbA1c greater than 6.0% should prompt further testing and closer follow-up 5
- HbA1c of 6.5-6.9% or greater, confirmed by a plasma glucose-specific test, should establish the diagnosis of diabetes 5
- HbA1c of 7% or greater, confirmed by another HbA1c- or a plasma glucose-specific test, should establish the diagnosis of diabetes 5