Diabetes Tests Worksheet
Diabetes Tests Worksheet
Below is a list of important tests. Provide the information requested 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 60 to 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 _______. Both the American Heart Association and the American Diabetes Association (ADA) recommend blood pressure of less than 130/80 mm Hg for people with diabetes (but the ADA recommends treating high blood pressure when the blood pressure rises to 140/90.) Have your blood pressure checked at every visit to your provider.
Foot exam
I have an appointment for a foot exam on ________. Check your feet every day for signs of redness, warmth, swelling or calluses. 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 that is not the same as having your vision checked for glasses.
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 develop a plan to reduce your risk. A 50% reduction from your baseline LDL cholesterol is the goal.
Urinary protein
My appointment for my urinary protein/microalbumin test is on ________. Measuring your urinary protein will give you and your 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) 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.
Updated:  
January 14, 2019
Reviewed By:  
Robert Hurd MD,Marianne Fraser MSN RN,Raymond Kent Turley BSN MSN RN