Definition and Overview
Diabetes follow-up is part of the diabetes care and management process. Its main objective is to monitor the progress of the disease so complications are anticipated, controlled, and managed quickly and effectively.
According to Centers for Disease Control and Prevention (CDC), at least 29 million people in the United States have diabetes, of which around 8 million remain undiagnosed.
Diabetes is a metabolic disease characterized by the non-production or failure of the body to correctly produce insulin, a hormone responsible for regulating blood sugar.
It doesn’t have any cure, and it can lead to different serious complications including kidney failure, vision loss, and nerve damage. However, it can be managed with regular follow-up and regular insulin injections.
Who Should Undergo and Expected Results
Diabetes follow-up is ideal for people diagnosed with:
Type 1 diabetes – Previously known as juvenile diabetes, type 1 diabetes refers to the body’s inability to produce insulin. It usually begins early such as during childhood and adolescent. Although new studies have shown that this can be controlled with surgeries such as pancreas transplant, the classic method of treatment is still regular insulin injection.
Type 2 diabetes – This is sometimes referred to as the lifestyle diabetes. It is more common among people who are overweight or morbidly obese, as well as those who are diagnosed with hypertension and heart disease. It occurs when the body begins to develop insulin resistance. The body becomes resistant to the hormone that the pancreas can no longer produce sufficient insulin that will deliver the glucose to the different cells. Thus, blood sugar increases.
Gestational diabetes – This is the kind of diabetes that affects pregnant women. There’s no definitive cause for it, but it also doesn’t mean that the mother has diabetes before conception. Usually, this goes away after giving birth. But while pregnant, it’s essential the mother’s sugar is carefully monitored to avoid complications like giving birth to babies with excess insulin.
Diabetes follow-up may also be performed among pre-diabetic or those who have high blood sugar but hasn’t gone through the diabetes threshold yet. It is also ideal for those who have high-risk factors like:
- Family history with diabetes
- Heart disease
- Endocrine disorder history
Diabetes follow-up is normally performed twice a year with at least one full physical checkup each year.
How Does the Procedure Work?
When it’s time for a follow-up, the patient visits the healthcare provider, who can be a general practitioner or a diabetes specialist, in a hospital or clinic.
The doctor first performs a physical exam followed by an interview. He may ask about any changes the patient may have experienced since his last visit like a change in vision, frequent numbness of the limbs, or a wound that takes much longer to heal.
He will also ask about:
- Physical activities
- Eating patterns
- History of hypoglycemic episodes
- Medications taken
- Other treatments
This is also the best time for the patient to air out his concerns.
The doctor may then request a series of exams for monitoring or for a more definitive answer to the patient’s concerns. These tests may include fasting blood sugar and urinalysis. The doctor may also check his blood pressure, creatinine, glomerular filtration rate (GFR), and liver function.
Depending on the results, the doctor will provide recommendations to keep the complications at bay, introduce or modify a treatment plan, or consider a referral to another specialist. The doctor also uses the follow-up time to educate the patient about self-care and diabetes management.
Possible Risks and Complications
Some people, especially those who lack proper education about the disease, may abandon follow-ups until complications begin to set in.
American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014;37 Suppl 1:S14-S80. PMID 24357209 www.ncbi.nlm.nih.gov/pubmed/24357209.
Buse JB, Polonsky KS, Burant CF. Type 2 diabetes mellitus. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2011: chap 31.