Diabetes Tests Worksheet
Below is a list of important tests. Provide the information asked for to see how you’re
doing.
A1c test
My last A1c test was on ________. The result was _________. This blood test measures blood sugar control over the past 90 days. A1c should be
tested 2 to 4 times a year, depending on how well your blood glucose is managed and
if you have had a recent change in your diabetes medicines. The target A1c level is mostly
below 7%.
Blood pressure
My blood pressure is _______. For people with diabetes and high blood pressure and low risk for heart and blood
vessel (cardiovascular) disease, the recommended target blood pressure is less than
140/90 mmHg. But if you're at risk for heart and blood vessel (cardiovascular) disease,
then the goal should be less than 130/80 if it can be safely attained. Have your blood
pressure checked at every visit to your provider. Ask your healthcare provider what
your blood pressure goal should be.
Foot exam
I have an appointment for a foot exam on ________. Check your feet and between your toes every day for signs of redness, warmth, swelling,
or calluses. Use a mirror to check the bottoms of your feet. In addition, have your
provider check your feet at every visit. And have a complete sensory foot exam done
every year.
Eye exam
My next dilated eye exam is on ________. People who have diabetes should have a dilated retinal exam every year. Remember
that this is a special eye exam. It's not the same as having your vision checked for
glasses. It involves the eye care provider putting drops in your eyes to dilate the
pupils so they can get a better look at the inside surface of the eye (the retina).
Lipid profile
I last had my fasting lipid profile on ________. Lipid profile tests should be done at least once a year. Then you and your healthcare
provider can create a plan to reduce your risk. A 50% reduction from your baseline
LDL cholesterol is often the goal. But the goal may vary according to your medical
history.
Urinary protein
My appointment for my urinary protein/microalbumin test is on ________. Measuring your urinary protein will give you and your healthcare provider information
about the health of your kidneys and blood vessels. You should have a test each year
for urinary protein/microalbumin if you have type 2 diabetes. Or if you have had type
1 diabetes for more than 5 years.
Kidney function
I last had my kidney function tested on ________. A blood test to check how well your kidneys are working (estimated glomerular filtration
rate or GFR) should be done at least once a year.
These are suggested guidelines for care. Check with your healthcare provider and insurance
benefits plan for coverage.