Patient information
Diabetes care
Diabetes care is a calendar, not a single number. A few checks come round on a rhythm, and each one watches a different part of your body. Here is the year, and the seven areas it covers.
What it is
Blood sugar is where diabetes starts, not where care ends
Diabetes harms small blood vessels, which feed the eyes, kidneys and nerves, and large ones, through hardening of the arteries. That is why care reaches well beyond a glucose reading.
Type 2 diabetes often begins quietly and is found late, so complications can already be present at diagnosis. Managing blood sugar, blood pressure and blood fats can delay or prevent them, and slow them once they start.
- Watch the eyes
Diabetes raises the risk of vision loss, including from retinopathy, damage at the back of the eye.
- Guard the kidneys
Protein in the urine is the earliest sign of diabetic kidney disease.
- Protect the feet
Nerve and blood vessel damage makes foot problems a common source of illness. Regular checks can reduce it.
- Care for the heart
Preventing heart and blood vessel disease is a major priority, especially in type 2 diabetes.
The year
A year of checks
Most checks repeat on a fixed rhythm. The one that changes pace is the A1C, a blood test that reflects your average blood sugar. The usual timings are shown below, so you can discuss which applies to you with your physician.
Many physicians also review your history and examine you two to four times a year.
These timings are a general guide, not a personal care plan. How often you are seen depends on your eyes, kidneys, treatment and goals. Do not pick your own interval.
How often to have an A1C test
A1C is a blood test that reflects your average blood sugar. How often you need it depends on your readings and treatment.
- About every6 months
When your blood sugar is steady and meeting the goals agreed with your physician.
- About every3 months
When your blood sugar is not yet at goal, or your treatment is changing.
Your physician decides when your next test is due. The checks below are part of your care too.
At every visit
- Blood pressure
- A look at your feet
Usually once a year
- Dilated eye exam
- Thorough foot exam
- Fasting blood fats (lipids)
- Basic metabolic profile
- Urine protein test
- Complete blood count
- Liver tests
- Dentist visit
Seven areas
What the calendar keeps watch over
The essentials for each area are below. Our physicians go through the detail with you.
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A1C every 3 to 6 months
Blood sugar
For most adults a reasonable goal is an A1C below 7 percent. It is set higher, for example below 8 percent, for older adults, people with other conditions and people who have had severe low sugar. If you use insulin or medicines that can cause low sugar, you check your own glucose from time to time.
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Blood pressure at every visit
Heart, blood pressure and cholesterol
High blood pressure is common and worth treating early, and cholesterol is checked regularly. Stopping smoking is among the most important steps for anyone with diabetes who smokes. Aspirin lowers the chance of another heart attack or stroke in people who have already had one; for everyone else it is decided one person at a time.
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Usually yearly
Eyes
Diabetes raises the risk of retinopathy, cataracts, glaucoma and sight that needs correcting. A dilated eye exam is usually yearly, and treatment given in time can reduce vision loss.
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Yearly
Kidneys
A yearly urine test for protein catches the earliest sign of kidney disease. Avoid vigorous exercise for 24 hours before it. Abnormal results are repeated, because false alarms are common. In type 2 diabetes, testing starts at diagnosis.
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Every visit
Feet and nerves
Your feet are looked at every visit and examined thoroughly at least once a year: skin, pulses and feeling. Numbness, calluses or deformities lead to a referral to a foot-care specialist.
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Mind, mouth and more
The rest of you
A dentist visit each year, even without teeth. Screening for low mood, anxiety and diabetes distress, the strain of self-care. Also hearing, sleep apnea, liver health, anemia and age and sex specific cancer screening.
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Yearly and as due
Vaccines
Influenza vaccine every year, plus pneumococcal, hepatitis B for unvaccinated adults under 60, tetanus and diphtheria, shingles, COVID-19, RSV and, up to age 26, HPV. The live nasal flu vaccine is not advised. Our physicians check which you need.
Treatment steps
What gets added when it is not enough
In type 2 diabetes, blood sugar tends to rise over time, so treatment often changes. Choose a step to see what it adds.
Changes in eating, exercise and weight are the three parts of treatment without medicines. Modest weight loss also lowers the chance of sleep apnea, helps mobility and can reduce how many glucose and blood pressure medicines you need.
Most people with type 2 diabetes start a medicine early, alongside these changes, unless something rules it out.
If blood sugar keeps rising, a second tablet or injectable medicine, or insulin, can be added.
The steps are a picture of the idea. Not everyone needs every step, and your physician decides what you take. Type 1 diabetes is treated with insulin matched to meals and activity, and diet and exercise matter there too.
Most people with type 1 diabetes are referred to an endocrinologist, a hormone specialist. Most people with type 2 are looked after by their primary care physician and team, with specialists involved when needed, for example when intensive insulin is required.
Your checks
Checks only help if they happen
If you live with diabetes, our physicians in Muscat can go through which checks you are due for and arrange them with you. Questions first? Contact us.
If you want a broader diabetes check, you can book a panel directly.
Worth raising with us if you
- Have diabetes and cannot recall your last eye exam
- Have not had a thorough foot exam this year
- Have not had a urine protein test this year
- Want your yearly checks organised
- Have type 1 diabetes
- Feel worn down by managing diabetes
- Smoke and want to stop
- Are unsure which vaccines you are due
Questions
What patients ask us
How often should I see a doctor if I have diabetes?
Many physicians review your history and examine you two to four times a year. Blood pressure and your feet are checked at every visit. Your own schedule depends on your health and treatment, and your physician sets it.
How often is the A1C test done?
A1C reflects your average blood sugar. It is usually measured about every six months when your sugar is steady and on target, and about every three months when you are not at goal or your treatment is changing.
Why check my eyes, kidneys and feet if I feel fine?
Type 2 diabetes often starts quietly and is found late, so complications can already be present at diagnosis. Regular checks find changes while treatment can still slow them and protect your sight.
Do I need a heart test if I have no heart symptoms?
Routine exercise stress testing is not usually done in people with diabetes who have no symptoms, because it has not improved outcomes beyond managing risk factors. A heart evaluation is considered if symptoms or other signs of heart or artery disease appear.
Why does my physician ask about my mood?
Depression and anxiety are common in people with diabetes, and the daily work of self-care can feel overwhelming. Screening is advised when diabetes is diagnosed and regularly afterwards.
Is diabetes looked after by a family physician or a specialist?
Most people with type 1 diabetes are referred to an endocrinologist. Most people with type 2 are cared for by their primary care physician and team, with specialists involved when needed, for example when intensive insulin is required.
Talk to a physician
Let us plan your year of checks
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This page is general information about diabetes care in adults who are not pregnant. It is not a diagnosis, and it does not replace advice from your physician.
Salam International Polyclinic · Building no. 2/710, Block no. 221, Way no.102, Madinat Sultan Qaboos, Muscat, Oman
Sun–Thu, 09:00–20:00