The New Year is a great time to gain focus and take the best care of oneself by reducing possible complications associated with diabetes. According to the American Heart Association, even though rates of heart attack and stroke are falling each year due to better medical treatment, an increase of unhealthy habits will ultimately reduce the positive gains.

In the A.H.A. Heart Disease and Stroke 2013 update, 2/3 of American adults are overweight or obese and 1/3 does not get any exercise. Outcomes for strokes and heart attacks have improved but a more productive way to handle it would be by some prevention. Trends including hypertension, obesity, and diabetes continue to grow in our nation. The update also states that 20% of Americans still smoke cigarettes and 47% of people being treated for hypertension are not even controlled.

As a way to increase your self knowledge, consider some of these examinations:

  1. Complete History and Physical (age 20-45) – If all is well this should be done every 5 years; but after the age of 45 – or when you have diabetes it should be performed yearly. Check with your physician if an EKG and/or a chest X-ray are also required.
  2. Hearing Exam – 30% of those over 60 have significant hearing loss. People with diabetes have increased risk of hearing loss and rarely get checked.
  3. Eye Exam – For those who have diabetes this is required yearly. The eye exam should include a dilatation so that the retinal be performed as well when the patient is older or has a family history. These conditions are more common with diabetes.
  4. Dental Exam – The area is visualized. Retinopathy, a leading complication in diabetes may not have symptoms until significant bleeding has taken place. A check for cataracts, glaucoma and macular degeneration should mouth and gums can offer you and the dentist lots of information about your overall health. Gum disease is associated with out of control blood sugars. Tooth decay continues throughout life and an oral cancer screening should be done. Try to have a check up at least every 6 months.
  5. Skin Exam – Some internists will do this exam but many times a dermatologist is needed; this should include a complete body check of all moles. Melanoma is the deadliest form of skin cancer and basal or squamous cell are very common especially when you have been exposed to the sun without sunscreen, have fair skin, light eyes, blond, red or balding hair as well as a family history.
  6. Blood Work – Your physician will be in charge of this part but you should follow up with the results, understand the results and keep a copy for future comparison. The blood tests should at least include a CBC, an A1C (every 3-4 months), a fasting glucose, a lipid profile for cholesterol, liver enzymes, possibly a CRP which can further predict cardiovascular disease and a thyroid check especially for women over 50. Thyroid disease is extremely common with diabetes.
  7. Blood Pressure Check – You should consider a blood pressure monitor for home use since hypertension is very common with diabetes. Think about bringing your machine to the visit to compare readings and remember your goal is always 130/80 or less. It is difficult to prescribe blood pressure medication based on one reading in the physician’s office and most people with diabetes are on these medications.
  8. Bone Density Test – Depending on your age, race, family history, physical size, alcohol or smoking history. 28 million Americans are at risk for osteoporosis and it is not only a woman’s disease. Broken hips from a fall are a leading cause for hospitalization when you are older. Discuss calcium intake or need for other bone building medications.
  9. Mammograms, Pap smear, Pelvic and Rectal Exam – Guidelines keep changing, so discuss your personal situation with your health care provider.
  10. Prostate Exam/Rectal Exam – Men over 50 or men who have a family history should get checked at age 40. The rectal exam should include a fecal occult blood test.
  11. Colonoscopy – Current guidelines suggest age 50 for the first test. Depending on the results anywhere between 3-10 years as a follow up. If you have a family history the guidelines suggest a test at an earlier age. It is one of the most common cancers for both men and women. The cure rate for colon cancer is 90% when caught in the early stages by this test.
  12. Immunizations – Discuss with your physician. Many people have personal opinions about immunizations. The A.D.A. does recommend a yearly flu shot for those who have diabetes. Check about a pneumonia shot depending on your age as well as a tetanus booster, shingles shot and hepatitis series.

Improved health is the best gift you can give yourself at any age and with any condition. I hope this New Year brings everyone peace and better health!


NOTE: Consult your Doctor first to make sure my recommendations fit your special health needs.

Roberta Kleinman

Roberta Kleinman

Roberta Kleinman, RN, M. Ed., CDE, is a registered nurse and certified diabetes educator. She grew up in Long Island, NY. Her nursing training was done at the University of Vermont where she received a B.S. R.N. Robbie obtained her Master of Education degree, with a specialty in exercise physiology, from Georgia State University in Atlanta, Georgia.

She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past.

She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.
Roberta Kleinman

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