I often call a client's last visit with me a "graduation." After the client and I have covered all the information they need to know to self-manage their diabetes and I really feel like they get it and are going to do a great job, that's when I meet with the client one more time -- for graduation. 

The following information is what I share with my clients during this final meeting. I talk to them about how they can prevent the complications from diabetes, going through with them a checklist of recommendations from the American Diabetes Association (ADA). There is more to managing diabetes than just controlling your glucose levels. Think of these recommendations as the ABCs.

• A1C. This is a blood test that represents an average of your glucose levels over the past 2 to 3 months. The goal is to have an A1C less than 7 percent. This test should be done by your doctor at least twice per year. If you are not reaching your goal, you may need to get your A1C measured 4 times per year.
  
• Blood pressure. High blood pressure increases your risk for a heart attack and stroke, and for kidney and eye disease. Your blood pressure should be measured at every doctor visit, and your goal should be a reading of 130/80 mmHg or lower.
  
• Cholesterol. Excessive fat circulating in the blood can build up in the arteries as plaque and cause a heart attack or a stroke. Make sure you have a lipid panel done annually. Targets are: 

                 o  total cholesterol: less than 200 mg/dL
                 o LDL (bad) cholesterol: less than 70 mg/dL
                 o HDL (good) cholesterol: more than 40 mg/dL for men and 50 mg/dL for women
                 o Triglycerides: less than 150 mg/dL

• Dental care. Diabetes can affect the mouth and increase your risk of gum disease. While the ADA doesn't offer specific guidelines for this, you should generally see your dentist every 6 months.
  
• Eye exam. You should have a dilated eye exam every year.
  
• Foot exam. At each appointment with your doctor, have your feet checked. At least once each year, you should have a thorough foot exam. 
  
• Get your microalbumin tested. This urine test, which looks for protein in the urine, is a more sensitive detector of kidney problems than a blood test. You should get the microalbumin test at least once per year, with a goal of less than 30 micrograms per milligram of creatinine.  

If you don't know when you last had these tests done, or if you are not sure of the results, ask your doctor. Remember: You are the one who manages your diabetes!