Diabetes FAQ — Common Questions About Type 2 Diabetes Treatment
1.What is diabetes and how does it develop?
Diabetes mellitus is a chronic condition where blood sugar (glucose) levels become elevated due to problems with insulin production or action. Insulin is a hormone from the pancreas that allows glucose to enter cells for energy.
When the system fails:
Types of diabetes:
- Type 1: autoimmune destruction of insulin-producing cells (5-10 percent of cases)
- Type 2: insulin resistance + progressive insulin deficiency (90 percent of cases)
- Gestational: develops during pregnancy
- Other types: MODY, LADA, secondary
Modern treatment uses multiple medication classes:
- Metformin like Glucophage and Glycoheal - first-line
- Sulfonylureas like Amaryl and Glucotrol
- DPP-4 inhibitors like Januvia
- SGLT2 inhibitors like Dapavel and Canagliflowin
2.What are the symptoms of diabetes?
Classic diabetes symptoms (memorized as "3 Ps"):
- Polydipsia - excessive thirst
- Polyuria - frequent urination
- Polyphagia - increased hunger
Other common symptoms:
- Unexplained weight loss (especially Type 1)
- Fatigue and weakness
- Blurred vision
- Slow-healing sores or cuts
- Frequent infections (skin, urinary, yeast)
- Numbness or tingling in hands/feet
- Recurrent gum infections
- Dry, itchy skin
Type 1 diabetes:
- Rapid onset over weeks
- Severe dehydration
- Fruity breath (ketones)
- Nausea and vomiting
- Confusion (severe)
- Diabetic ketoacidosis risk (medical emergency)
Type 2 diabetes:
- Often gradual and subtle onset
- Symptoms may be mild for years
- Many diagnosed on routine screening
- Damage may occur before diagnosis
Seek immediate care for: nausea, vomiting, fruity breath, severe abdominal pain, confusion, or unconsciousness - possible diabetic ketoacidosis (DKA).
Testing recommended if you have symptoms or risk factors (family history, obesity, age over 45, high blood pressure).
3.What diabetes medications does RXshop offer?
RXshop offers 18 diabetes medications across all major classes:
Metformin (first-line):
Sulfonylureas:
Meglitinides:
TZDs:
Alpha-glucosidase inhibitor:
DPP-4 inhibitors:
SGLT2 inhibitors:
Combinations:
- Oxramet XR, Oxramet-S XR (triple)
Diabetes insipidus: DDAVP (Desmopressin)
4.How does metformin work and why is it first-line?
Glucophage (Metformin 850mg) and Glycoheal (Metformin 1000mg) are the first-line medications for Type 2 diabetes.
How metformin works:
Why metformin is preferred:
- Effective HbA1c reduction (1-2 percent)
- Low hypoglycemia risk
- Weight-neutral
- Cardiovascular benefits possible
- Low cost
- Extensive safety data (60+ years use)
- Available as extended-release for better tolerance
Common side effects:
- GI upset - nausea, diarrhea, cramping (usually resolves in 1-2 weeks)
- Take with food to reduce GI effects
- Start low, titrate up slowly
- Metallic taste
Important warnings:
- Lactic acidosis - rare but serious
- Avoid in severe kidney disease
- Hold before contrast dye studies
- Long-term use may cause vitamin B12 deficiency
- Avoid excessive alcohol
5.What is HbA1c and what should my target be?
HbA1c (glycated hemoglobin) reflects average blood glucose over the past 2-3 months. Gold standard for diabetes diagnosis and monitoring.
How it works:
- Glucose attaches to hemoglobin in red blood cells
- Level rises when average glucose higher
- Reflects long-term control
- No fasting required for test
- Test every 3-6 months typically
HbA1c categories:
- Normal: under 5.7 percent
- Prediabetes: 5.7-6.4 percent
- Diabetes: 6.5 percent or higher
Treatment targets:
- Most adults with diabetes: under 7 percent
- Young, healthy diabetics: under 6.5 percent (if achievable safely)
- Elderly or complex patients: 7.5-8 percent
- Very elderly/frail: individualized approach
- Pregnancy: under 6 percent
HbA1c to average glucose conversion:
- 6 percent = 126 mg/dL average
- 7 percent = 154 mg/dL average
- 8 percent = 183 mg/dL average
- 9 percent = 212 mg/dL average
- 10 percent = 240 mg/dL average
Benefits of good control:
- Reduced eye, kidney, nerve complications
- Lower cardiovascular events
- Better daily wellbeing
- Fewer hypoglycemic episodes
- Each 1 percent reduction significant benefit
Modern medications like Januvia, Dapavel, and metformin help achieve targets safely.
6.How do SGLT2 inhibitors work?
Dapavel, Canagliflowin, Dapasmart, and Dapanta are SGLT2 inhibitors - newer diabetes medications with impressive additional benefits.
How SGLT2 inhibitors work:
Benefits beyond glucose control:
- Cardiovascular protection - reduces heart attacks, deaths
- Heart failure benefit - reduces hospitalizations and death
- Kidney protection - slows CKD progression
- Weight loss - typically 2-3 kg
- Modest blood pressure reduction
- Low hypoglycemia risk
- Once-daily dosing
Important side effects:
- Genital fungal infections - common
- UTIs - increased risk
- Dehydration - increase fluid intake
- Diabetic ketoacidosis - rare but serious (even at normal glucose)
- Fournier gangrene - very rare
- Bone fractures (canagliflozin specifically)
- Reduced effectiveness in advanced kidney disease
Increasingly used in patients with heart failure or CKD regardless of diabetes status.
7.What are the risks of hypoglycemia (low blood sugar)?
Hypoglycemia (low blood sugar) can be life-threatening if severe. Learn to recognize and treat quickly.
What is hypoglycemia?
- Blood glucose below 70 mg/dL
- Severe if below 54 mg/dL
- Serious if under 40 mg/dL
Symptoms of hypoglycemia:
- Mild: shakiness, sweating, hunger, palpitations, anxiety
- Moderate: confusion, difficulty concentrating, blurred vision, dizziness
- Severe: loss of consciousness, seizures, coma
Medications that cause hypoglycemia:
Low hypoglycemia risk (used alone):
- Metformin (Glucophage)
- DPP-4 inhibitors (Januvia)
- SGLT2 inhibitors (Dapavel)
- TZDs (Actos)
Treatment (rule of 15):
Severe hypoglycemia (unconscious): Glucagon injection, emergency call.
8.What is diabetic ketoacidosis (DKA)?
Diabetic ketoacidosis (DKA) is a life-threatening medical emergency requiring immediate hospital treatment.
What is DKA?
- Severe insulin deficiency
- Body burns fat for energy
- Ketones accumulate causing acidosis
- High blood sugar
- Dehydration
- Electrolyte disturbances
Symptoms of DKA:
- Nausea and vomiting
- Abdominal pain
- Deep, rapid breathing
- Fruity breath odor (ketones)
- Excessive thirst
- Frequent urination
- Confusion
- Fatigue and weakness
- Loss of consciousness (severe)
Common triggers:
- Missing insulin doses
- Infections
- Illness
- Injury or surgery
- Stress
- Some medications
- Alcohol or drug use
- Undiagnosed diabetes
Who is at risk:
- Type 1 diabetes (most common)
- Some Type 2 cases
- Patients on SGLT2 inhibitors (rare, even at normal glucose)
Prevention:
- Never skip insulin doses
- Monitor glucose regularly
- Check ketones during illness
- Adequate hydration
- Sick day management plan
- Prompt attention to symptoms
Emergency treatment:
- IV insulin
- IV fluids
- Electrolyte replacement
- Address triggering cause
- Hospital care essential
Do NOT delay - DKA can be fatal within hours if untreated.
9.How does Januvia (Sitagliptin) work?
Januvia (Sitagliptin 100mg) and Sitasmart (Sitagliptin 50mg) are DPP-4 inhibitors that enhance the incretin system.
How DPP-4 inhibitors work:
Advantages:
- Low hypoglycemia risk
- Weight-neutral
- Once-daily dosing
- Well-tolerated
- Simple regimen
- Effective as add-on to metformin
- Can be used with other diabetes medications
Modest efficacy:
- HbA1c reduction 0.5-0.8 percent
- Less than metformin, sulfonylureas, or SGLT2 inhibitors
- Better as add-on than monotherapy
Uses:
- Add-on to metformin (most common)
- Alternative when metformin not tolerated
- Elderly patients (safer profile)
- Kidney disease (dose adjust)
Important considerations:
- Rare pancreatitis risk - report severe abdominal pain
- Rare severe joint pain
- Higher cost than older medications
- Adjust for kidney function
- Skin reactions rare
10.What is the difference between Type 1 and Type 2 diabetes?
Type 1 and Type 2 diabetes are fundamentally different conditions despite similar symptoms.
Oral medications like Glucophage, Januvia, and Dapavel** work for Type 2 but do not replace insulin needed in Type 1.
11.How can Type 2 diabetes be prevented?
Type 2 diabetes is largely preventable through lifestyle modifications, especially for those with prediabetes or risk factors.
Risk factors:
- Family history
- Overweight/obesity (especially abdominal)
- Age over 45
- Sedentary lifestyle
- Prediabetes
- Gestational diabetes history
- Ethnic background (higher rates in some populations)
- Hypertension
- Abnormal cholesterol
- PCOS
Prevention strategies:
- Weight loss - 5-10 percent significantly reduces risk
- Regular exercise - 150 minutes moderate weekly
- Healthy diet - Mediterranean, DASH
- Limit refined carbs and sugary drinks
- Increase fiber
- Adequate sleep (7-9 hours)
- Stress management
- Regular screening
Prediabetes management:
- Diabetes Prevention Program shown to reduce diabetes 58 percent
- Intensive lifestyle intervention
- Sometimes metformin considered
- Regular monitoring
Landmark studies:
- Diabetes Prevention Program: lifestyle beat metformin
- Finnish Diabetes Prevention Study: similar results
- Both showed sustained benefit years later
Getting started:
- Know your risk (family history, testing)
- Assess prediabetes with HbA1c or fasting glucose
- Meet with dietitian
- Start walking program
- Track weight regularly
- Consider diabetes prevention program
Even small changes make big difference - starting is most important step.
12.What diet is best for diabetes?
No single "diabetic diet" is best - individualized approach works best. Focus on quality foods and portion control.
Proven dietary approaches:
- Mediterranean diet - strong evidence for diabetes and cardiovascular benefit
- DASH diet - lower blood pressure and glucose
- Low-carb diets - effective for weight loss and glucose
- Plant-based diets - beneficial for many
- Diabetes plate method - visual approach
Emphasize:
- Non-starchy vegetables (fill half plate)
- Lean proteins (chicken, fish, tofu, beans)
- Whole grains (quinoa, brown rice, oats)
- Healthy fats (olive oil, nuts, avocado)
- Fruits in moderation
- Low-fat dairy or alternatives
- Water as main beverage
Limit:
- Sugary drinks (soda, juice)
- Refined carbs (white bread, pastries)
- Fried foods
- Processed foods
- Excessive saturated fats
- Excessive sodium
- Alcohol
Carbohydrate counting:
- Match insulin to carb intake
- Read food labels
- Consistent meal patterns
- Learn portion sizes
Meal timing:
- Consistent meal times
- Do not skip meals (especially on insulin/sulfonylureas)
- Consider intermittent fasting cautiously (medical supervision)
Sugar substitutes:
- Can be used in moderation
- Read labels
- Some may affect gut bacteria
- Whole foods preferred over sweeteners
Registered dietitian consultation valuable for personalized guidance.
13.When should I check my blood sugar?
Blood glucose monitoring frequency depends on type of diabetes, medications, and stability.
Type 1 diabetes (essential):
- Before each meal
- Bedtime
- Sometimes overnight
- Before exercise
- When feeling unwell
- Total: 4-10 times daily
- Continuous glucose monitors (CGM) increasingly common
Type 2 with insulin:
- Before meals
- Bedtime
- Similar to Type 1
Type 2 without insulin:
- Less frequent monitoring
- Before meals when starting/adjusting medications
- Fasting glucose several days per week
- Occasional post-meal testing
When to check regardless of regimen:
- Symptoms of hypoglycemia
- Symptoms of hyperglycemia
- During illness
- Before driving
- Before/after exercise
- When taking new medications
- With changes to routine
Target ranges (individualized):
- Fasting: 80-130 mg/dL
- Before meals: 80-130 mg/dL
- 2 hours after meals: under 180 mg/dL
- Bedtime: 100-140 mg/dL
Continuous Glucose Monitors (CGM):
- Real-time glucose readings
- Trend arrows show direction
- Alerts for high/low
- Reduce need for fingersticks
- Increasingly used in Type 2 also
Keep a log - identify patterns, share with healthcare team.
Modern medications like Januvia, Dapavel, and metformin have lower hypoglycemia risk requiring less monitoring.
14.What are the long-term complications of diabetes?
Uncontrolled diabetes damages virtually every organ system. Good control prevents most complications.
Cardiovascular complications:
- Heart attack (2-4 times higher risk)
- Stroke (increased risk)
- Peripheral artery disease
- Heart failure
- Leading cause of death in diabetes
Kidney complications (nephropathy):
- Diabetic nephropathy
- Leading cause of kidney failure
- Progression: microalbuminuria to overt kidney disease
- May require dialysis or transplant
Eye complications (retinopathy):
- Leading cause of adult blindness
- Diabetic retinopathy
- Macular edema
- Cataracts (earlier onset)
- Glaucoma (increased risk)
Nerve complications (neuropathy):
- Peripheral neuropathy (numbness, tingling, pain)
- Autonomic neuropathy
- Gastroparesis
- Sexual dysfunction
- Foot ulcers risk
Foot complications:
- Ulcers
- Infections
- Amputation risk
- Daily inspection essential
Other complications:
- Skin conditions
- Dental problems
- Hearing loss
- Depression
- Cognitive decline/dementia
- Certain cancers
- Sleep apnea
Prevention:
- Good glucose control
- Blood pressure control
- Cholesterol management
- Weight management
- Smoking cessation
- Regular screening
- Foot care
- Annual eye exams
- Vaccinations
Modern medications like SGLT2 inhibitors (Dapavel, Canagliflowin) offer cardiovascular and kidney protection.
15.What is prediabetes and what should I do about it?
Prediabetes means blood sugar higher than normal but not yet in diabetes range. Approximately 96 million US adults have prediabetes - many undiagnosed.
Prediabetes diagnosis:
- Fasting glucose 100-125 mg/dL
- HbA1c 5.7-6.4 percent
- 2-hour glucose tolerance 140-199 mg/dL
Why it matters:
- Progression to Type 2 diabetes: 5-10 percent yearly
- Increased cardiovascular risk already
- Damage may begin during prediabetes
- Highly preventable with intervention
Screening recommended for:
- All adults age 45+
- Overweight adults with risk factors
- Family history of diabetes
- Gestational diabetes history
- High-risk ethnic groups
- Hypertension
- PCOS
- Cardiovascular disease
Prevention strategies (Diabetes Prevention Program):
- Weight loss 5-10 percent - reduces diabetes 58 percent
- Physical activity 150 minutes weekly
- Reduce total fat intake (especially saturated)
- Increase fiber (14g per 1000 calories)
- Reduce calories if overweight
- Structured programs available
Medication consideration:
- Metformin (Glucophage) sometimes prescribed for prediabetes
- Especially in higher-risk individuals
- BMI over 35
- Age under 60
- Women with prior gestational diabetes
Monitor:
- HbA1c every 6-12 months
- Weight regularly
- Blood pressure
- Cholesterol
Realistic and empowering - lifestyle changes truly work to prevent progression.
16.Can diabetes medications be taken during pregnancy?
Most oral diabetes medications are avoided during pregnancy. Insulin is preferred treatment.
Preferred approach:
- Insulin - primary treatment
- Multiple daily injections common
- Insulin pumps sometimes used
- Continuous glucose monitors valuable
- Tight control essential
Metformin in pregnancy:
- Sometimes used for gestational diabetes
- PCOS treatment sometimes continues
- Individual decisions
- Evidence generally supportive
Generally AVOIDED in pregnancy:
- Sulfonylureas: Amaryl, Glucotrol
- SGLT2 inhibitors: Dapavel, Canagliflowin
- DPP-4 inhibitors
- TZDs: Actos, Avandia
- Meglitinides
- Acarbose
Gestational diabetes:
- Screening at 24-28 weeks pregnancy
- Higher risk women screened earlier
- Diet and exercise first-line
- Insulin if control inadequate
- Metformin sometimes considered
- Usually resolves after delivery
Pregnancy targets (tighter than usual):
- Fasting: under 95 mg/dL
- 1 hour post-meal: under 140 mg/dL
- 2 hours post-meal: under 120 mg/dL
- HbA1c: under 6 percent
Pre-pregnancy planning:
- Achieve HbA1c under 6.5 percent
- Switch to pregnancy-safe medications
- Optimize all diabetes care
- Multidisciplinary team
- Folic acid supplementation
Postpartum: Screening for Type 2 recommended after gestational diabetes.
17.What is diabetes insipidus and how is it different?
Diabetes insipidus (DI) is a completely different condition from diabetes mellitus, despite sharing the "diabetes" name. Involves fluid balance and antidiuretic hormone (ADH), NOT blood sugar.
Why called "diabetes":
- Greek word meaning "to pass through" (excessive urination)
- Both conditions cause increased urination
- Similar historical symptoms description
- Completely different mechanisms
What causes DI:
- Central DI: pituitary produces insufficient ADH
- Nephrogenic DI: kidneys unresponsive to ADH
- Dipsogenic DI: excess thirst causing dilute urine
- Gestational DI: during pregnancy
Symptoms:
- Extreme thirst
- Excessive urination (3+ liters daily)
- Very dilute urine
- Dehydration
- Sleep disturbances
Diagnosis:
- Water deprivation test
- Vasopressin (ADH) levels
- Urine osmolality
- MRI to rule out pituitary problems
Treatment:
- DDAVP (Desmopressin 2.5ml/10mcg) - synthetic ADH
- Available as nasal spray, tablets, injection
- Replaces deficient hormone
- Adequate fluid intake
- Address underlying cause
DDAVP other uses:
- Nocturnal enuresis (bedwetting)
- Bleeding disorders (von Willebrand disease)
- Some other specific indications
Not related to blood sugar - patients with diabetes insipidus do NOT need metformin or other glucose-lowering medications.
18.What drug interactions should I know about with diabetes medications?
Diabetes medications have many important drug interactions that can affect glucose control or cause side effects.
Medications that may raise blood sugar:
- Corticosteroids (prednisone) - major impact
- Some diuretics (thiazides)
- Antipsychotics
- Beta-blockers
- Some immunosuppressants
- Some HIV medications
- Statins (small effect)
Medications that may lower blood sugar or increase hypoglycemia:
- Alcohol - especially on empty stomach
- Beta-blockers - mask hypoglycemia symptoms
- Sulfonamide antibiotics
- ACE inhibitors
- Aspirin at high doses
Metformin interactions:
- Contrast dye - hold before imaging
- Cimetidine - increases levels
- Alcohol - lactic acidosis risk
- Some antibiotics affect kidney function
Sulfonylurea interactions:
- Fluconazole and similar - increase hypoglycemia
- Warfarin - variable
- Beta-blockers - hypoglycemia effects
SGLT2 inhibitor considerations:
- Diuretics - dehydration risk
- Insulin/sulfonylurea combination - hypoglycemia
- NSAIDs - kidney effects
DPP-4 inhibitor interactions:
- Generally few interactions
- Some rare pancreatitis reports
Best practices:
- Complete medication list to all providers
- Include supplements and OTC medications
- Discuss any new medications
- More frequent monitoring during interactions
- Alert to hypoglycemia symptoms
19.What foot care is important for diabetes?
Foot care is critical for diabetics - approximately 15 percent develop foot ulcers, and diabetes is leading cause of non-traumatic amputation.
Why diabetics need special foot care:
- Neuropathy reduces sensation - injuries unnoticed
- Poor circulation impairs healing
- Higher infection risk
- Small problems become serious
- Ulcers can lead to amputation
Daily foot care:
- Inspect feet daily - look for cuts, blisters, redness, swelling
- Use mirror to see bottom of feet if needed
- Ask family member to help if vision poor
- Wash daily with warm (not hot) water
- Dry thoroughly, especially between toes
- Moisturize tops and bottoms (not between toes)
- Keep toenails trimmed straight across
- Do not trim corns or calluses yourself
Footwear:
- Wear well-fitting shoes always
- Never walk barefoot
- Check inside shoes before wearing
- Wear clean, dry socks
- Avoid tight socks
- Consider diabetic shoes if needed
When to see doctor/podiatrist:
- Any injury or wound
- Redness, warmth, swelling
- Ingrown toenails
- Corns or calluses
- Changes in sensation
- Changes in color
- Cold or warm areas
- Any concerns
Regular professional care:
- Annual foot exam by physician
- Podiatrist for nail care, calluses
- Monofilament testing for sensation
- Assessment for peripheral artery disease
Prevention essentials:
- Good glucose control
- Do not smoke
- Manage cardiovascular risk factors
- Regular exercise
20.How do I manage diabetes during illness?
Illness affects diabetes control significantly. Have a sick day plan discussed with your healthcare team.
Why illness affects diabetes:
- Stress hormones raise glucose
- Infections raise glucose
- Reduced eating changes needs
- Vomiting/diarrhea affect absorption
- Dehydration risk
- DKA risk (especially Type 1)
General sick day rules:
- Never stop insulin (Type 1) - may need MORE during illness
- Check glucose more frequently (every 2-4 hours)
- Check ketones if glucose over 240
- Stay hydrated
- Try to eat/drink carbs if possible
- Rest
- Have sick day plan ready
What to drink:
- Water
- Broth
- Sugar-free beverages if glucose high
- Regular sports drinks or juice if glucose low
- Ice chips if nauseous
What to eat:
- Small amounts frequently
- Bland foods
- Crackers, toast
- Applesauce
- Yogurt
- Broth-based soups
When to call doctor:
- Cannot keep food/fluids down
- Glucose over 240 for 2+ readings
- Ketones present
- Vomiting persistent
- Symptoms of DKA
- Illness lasts more than 2 days
- Signs of dehydration
- Confusion
- High fever
SGLT2 inhibitor considerations:
- Hold during severe illness or dehydration
- DKA risk even at normal glucose
- Consult doctor
Emergency signs:
- Signs of DKA (nausea, vomiting, fruity breath)
- Signs of severe hypoglycemia
- Dehydration
- Chest pain
- Difficulty breathing
21.How does exercise affect diabetes?
Exercise is essential for diabetes management with multiple benefits. Modifications sometimes needed based on medications.
Exercise benefits:
- Lower blood glucose - immediate effect
- Improves insulin sensitivity - lasts 24-48 hours
- HbA1c reduction - 0.5-1.0 percent
- Weight management
- Cardiovascular protection
- Better sleep
- Improved mood
- Reduced complications
- Stronger bones and muscles
Recommended exercise:
- 150 minutes moderate aerobic weekly
- OR 75 minutes vigorous
- Plus strength training 2-3x weekly
- Flexibility/balance exercises
- Spread throughout week
- No more than 2 consecutive rest days
Best types of exercise:
- Walking (easiest to start)
- Swimming
- Cycling
- Dancing
- Team sports
- Resistance training
- Yoga, tai chi
Precautions with insulin/sulfonylureas:
- Check glucose before - do not exercise if under 100 mg/dL
- Carry fast-acting carbs
- Adjust insulin doses
- Consider timing of medications
- Check glucose after
- Watch for delayed hypoglycemia
- Avoid vigorous exercise if glucose over 250 with ketones
Modern medications like metformin, DPP-4 inhibitors (Januvia), and SGLT2 inhibitors (Dapavel) do not cause exercise-induced hypoglycemia when used alone.
Safety considerations:
- Wear medical ID
- Foot inspection
- Proper footwear
- Stay hydrated
- Warm up and cool down
- Start slowly
- Progress gradually
- Address exercise safety with doctor if complications
22.When should I see a doctor about diabetes?
EMERGENCY - Call 911 for:
- Signs of DKA (nausea, vomiting, fruity breath, confusion, deep breathing)
- Severe hypoglycemia (unconscious, seizure)
- Loss of consciousness
- Chest pain or stroke symptoms
- Signs of severe infection
- Severe abdominal pain (possible pancreatitis)
- Fournier gangrene signs (perineal pain, swelling)
See doctor promptly for:
- New diabetes symptoms (3 Ps)
- HbA1c not at target
- Frequent hypoglycemia
- Difficulty controlling glucose
- New complications
- Foot problems or wounds
- Vision changes
- Kidney concerns
- Persistent side effects
- Pregnancy planning
- Weight changes (loss or gain)
- Elevated blood pressure
- New medications needed
Regular follow-up schedule:
- Primary care/endocrinology: every 3-6 months
- HbA1c: every 3-6 months
- Blood pressure: every visit
- Lipid panel: annually
- Kidney function: annually (urine microalbumin, blood creatinine)
- Comprehensive foot exam: annually
- Comprehensive eye exam: annually
- Dental exam: every 6 months
- Vaccinations: flu yearly, pneumonia, COVID-19
Specialist referrals:
- Endocrinologist for complex diabetes
- Ophthalmologist for eye disease
- Nephrologist for kidney disease
- Cardiologist for heart disease
- Podiatrist for foot problems
- Diabetes educator for self-management
- Registered dietitian for nutrition
- Mental health for depression/coping
Never delay evaluation for concerning symptoms - diabetes complications preventable with prompt attention.
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