| There are many potential complications of | | | | Microalbumin is the name for microscopic proteins |
| diabetes. The four most common are heart | | | | that are found in the urine when the kidneys are |
| disease (hardening of the arteries), nephropathy | | | | damaged by poorly controlled diabetes, and can |
| (kidney damage), neuropathy (nerve damage), | | | | be detected by a simple urine test. Testing for |
| and retinopathy (eye damage). Treating diabetes, | | | | blood urea nitrogen (BUN), creatinine, and an |
| blood pressure, and cholesterol to recommended | | | | estimated glomerular filtration rate (eGFR) are |
| treatment will help to prevent these complications. | | | | blood tests that evaluate kidney function, and |
| HEART DISEASE | | | | should be done on a routine basis. |
| The most common complication of diabetes and | | | | NEUROPATHY (NERVE DAMAGE) |
| the leading cause of death in people with diabetes | | | | Diabetic peripheral neuropathy most commonly |
| is heart disease or hardening of the arteries. | | | | occurs in the feet. Since the nerves that travel |
| Screening for heart disease is done differently | | | | from your brain to your feet and vice versa are |
| than screening for kidney, eye, and nerve | | | | the longest nerves in your body, they are the |
| damage in that we do not specifically screen the | | | | nerves mostly likely to be damaged by poorly |
| heart. Instead, it is recommended that we screen | | | | controlled diabetes. The best way to screen for |
| for and treat the risks factors for heart disease. | | | | diabetic nerve damage is having your feet |
| It would be impractical, expensive, and unreliable; | | | | examined on a regular basis. Take your shoes and |
| for example, to perform a stress test designed | | | | socks off when you visit your primary care |
| to diagnose heart disease on all people with | | | | provider so your feet can be thoroughly |
| diabetes. Thus, we screen for the six major risk | | | | examined. You should have a specific test called |
| factors for heart disease: | | | | monofilament testing which evaluates your feet |
| 1. Diabetes | | | | for normal touch sensation. |
| 2. High blood pressure | | | | RETINOPATHY (EYE DAMAGE) |
| 3. High cholesterol | | | | It is sad to say but diabetes is the leading cause |
| 4. Smoking | | | | of blindness in America. I truly believe that |
| 5. Family history (having an aunt, uncle, parent, | | | | blindness related to diabetes is nearly completely |
| child or sibling with premature or early heart | | | | preventable with good control of glucoses, good |
| disease, which includes heart attacks, angioplasty, | | | | blood pressure control, and yearly screening. |
| stent placements or coronary artery bypass | | | | Screening for retinopathy is done by having a |
| grafting before the age of 60) | | | | yearly eye exam that includes dilating your eyes |
| 6. Age (men greater than age 45 and women | | | | with eye drops and looking in the back of your |
| greater than age 55). | | | | eyes. What the eye doctor is examining are the |
| Once any of these risk factors are identified, we | | | | small blood vessels in the retina (the back of your |
| need to then treat them to the recommended | | | | eyes) that can be damaged from poorly |
| treatment goals. | | | | controlled diabetes. The vision testing done during |
| NEPHROPATHY (KIDNEY DAMAGE) | | | | the exam is merely an extra-added bonus. |
| Diabetes is the leading cause of kidney failure | | | | The take home message is: it very important to |
| leading to dialysis in the United States. Screening | | | | screen for the common complications of diabetes, |
| for diabetic nephropathy consists of having your | | | | so that any problems can be identified early or, |
| urine tested for microalbumin on a yearly basis. | | | | ideally, prevented. |