Assessment of the established diabetic

Continuing assessment of the diabetic patient has three main aims which are to educate the diabetic patient, to find out what problems the diabetic patient is experiencing (glycemic control and morale), and to find out or pre-empt diabetic complications. 

Assessing the glycaemic control in the diabetics can be done from the glycated (glycosylated) haemoglobin levels relating to mean glucose levels over the past eight weeks. The target HbA1c must be set individually per each diabetes patient. Tight or more regular control of HbA1c is highly needed in pregnancy women that have diabetes and others that have micro-vascular complications during diabetes. The elderly diabetic patient may have need for lesser tight control of HbA1c. 

Diabetes and diabetic complications generally increase with increasing HbA1c. Also note that fructosamine in the form of glycated plasma protein relates to diabetes or blood sugar control for the past one to three weeks. This could be very helpful and useful during pregnancy state for assessing and checking shorter term control of diabetes and blood sugar, and also if there is an underlying medical condition interfering with accurate measurement of HbA1c as being observed in some form of hemoglobinopathies. Other methods of assessing glycaemic control are taking the history of hypoglycemic attacks whether with symptoms, and use of home finger stick glucose records.

Assessment of diabetes complications is very important and helpful. This can be done by checking injection sites for infection, lipoatrophy, or lipohypertrophy. 

Diabetic complication assessment needs to cover vascular disease check, which is the most common cause of death in the diabetics resulting from cerebrovascular, cardiovascular, and peripheral vascular complications. This will help to reduce the chances of stroke from occurring which is more common in the diabetes mellitus patients. The kidneys and the renal system need to be regularly checked in the diabetics, checking for the urine creatinine clearance and checking albuminuria.

 This will help to prevent diabetic nephropathy and prevent early renal/kidney diseases in diabetes. Control of hypertension/or high blood pressure in diabetes can as well be very helpful for the diabetics as it will help to reduce and out rule the chances of stroke or cardiac/heart problems from arising as much as preserving the kidneys from being injured. Blindness as one of the complications of diabetes mellitus can be prevented. Loss of sight in diabetes is called diabetic retinopathy. 

It is quiet common in diabetic individual, but it (diabetic retinopathy) is quiet preventable through regular fundoscopy for all diabetic patients , including retinal photography and possible screening to know if laser photocoagulation can be used. Other eye complications in diabetes are cataracts, rubeosis iridis, which are all preventable when the blood sugar is kept under tight control.

Diabetic complications as seen in diabetes individuals, especially type 1 diabetes are complications arising from metabolic derangement, diabetic feet and diabetic neuropathy, all which, can be very well averted or prevented if the diabetes is well managed, treated or better still given a diabetes cure approach.