Contributor: Contributor: Jennifer Smith, RD, LD, CDCES
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Life has many transition stages - childhood, teen years, young adulthood, and so on. We are constantly changing, especially as we move farther through adulthood.

Since we live with diabetes, there is usually a lot of focus surrounding necessary tests that ensure healthy diabetes management. But how often do you consider other simple health evaluations? Yearly health screenings for many different things should be considered and aren't always addressed unless you follow up with your primary care physician. Health assessment for preventative care changes based on age range, so your provider should look at the current and past tests, the date completed, and when they need to be completed again. Often, preventative care tests can detect something out of range earlier rather than later, leading to more optimized treatment and better long-term outcomes.

You may have had some baseline results that were done years ago, and these can be an excellent tool to evaluate the current tests you'll have completed. If you haven't been prescribed medications for anything other than diabetes, the baseline for other tests will enable your medical team to determine if a medication needs to be added. It is always important to discuss additional medications with both your primany care physician and your endocrine team to determine how they may impact your overall glucose management.

As a woman, what health screenings are necessary, and when should they be completed? Initial screenings should start at age 18. A lot happens once you are an adult, and as life rolls quickly - people often push off other health screenings. The Wellness checkups or Well-person screenings listed below are usually covered by insurance. Some businesses incentivize employees to meet yearly health screening recommendations and stay in the target area for test results.

Annual screenings for women 18 – 29 years of age:

• Blood pressure – annually, but checks should be done more frequently if an established risk is found.
• Cholesterol panel – Total Cholesterol, LDL, HDL, and Triglycerides. Women with diabetes should complete these screenings annually, with closer follow-up if medication is added due to your results.
• Blood Work – complete blood count (CBC), Thyroid, Liver enzymes, Basic metabolic panel (BMP).
• Weight and Height – These parameters should be taken at endocrinologist visits so adjustments can be made to medication if a weight change is considerable.
• Family Health History – An annual review for changes in health issues of your blood relative, such as heart disease and cancer.
• Immunization – Should be reviewed to ensure all is up to date since the last evaluation.
• Cervical Cancer Screening – pap smear every three years unless issues were identified and treated, then follow the schedule set by your healthcare team following treatment.

Annual screenings for women 40 - 64 years of age: All screenings above should continue but may be adjusted to every other year or a different time frame, depending on your current health. Additional screenings and immunizations to consider include:

• Colonoscopy
• Cancer
• Mammogram - starting at age 40 (should be postponed for 6 months if nursing).
• Immunizations - for shingles (starting at age 50 and up) and annual flu shot.
• Osteoporosis / Bone Density - starting at age 50 and up.
• Colorectal screening - starting at age 50 and up.
• Lung cancer - at age 55 and up or yearly if there is a history of smoking.
• Pelvic exam and Pap Smear - may be adjusted to every three years depending on health history.

Annual screenings for women 65 years and Older: All tests and screenings above should continue in this age group. Discuss changes to the screening schedule with your healthcare team. Additional considerations include:

• Weight and Height – Evaluate for stability. Women tend to start losing weight after age 65 due to the loss of lean muscle tissue. Loss of height can increase after age 70, so evaluate yearly after age 65. Discuss how to prevent further loss with lifestyle adjustments such as intake of healthy nutrients and exercise to maintain bone and muscle health.
• Screening for Fall prevention – along with a loss of balance as we age, issues related to diabetes may need to be reassessed. Neuropathy, or nerve damage, especially in the feet and toes, can lead to a loss of balance, increasing the risk of falls and breaking bones.

In addition, regardless of age, we should screen for depression with a mental health assessment. Life with a chronic condition such as diabetes can take a toll on mental health. It is essential to consider evaluation for a baseline and continue ongoing screenings. Things change so much as we age; sometimes, an additional health concern beyond diabetes can be too much more to manage. Having a good healthcare team that knows you well can be beneficial if you find you need some mental health support at any point.

Don't forget your regular screenings for diabetes management as well: Every 3, 6, or 12 months depending on current health. While not all these tests are specific to diabetes care, the results can impact your diabetes management.

• A1C
• Cholesterol
• Microalbumin
• Thyroid
• Blood Pressure
• Foot Exam
• Eye Exam with Ophthalmologist
• Dental Exam
• Electrocardiogram (>50 years of age)

Jennifer Smith, RD, LD, CDCES, Director of Lifestyle and Nutrition, has lived with diabetes since childhood and has first-hand knowledge of diabetes management. She is passionate about achieving healthy nutrition and fitness goals while living with diabetes. In 2009 she completed her first 70.3 triathlon, which brought a deeper understanding of athletic training requirements and the importance of nutrition to realize athletic goals.

Jennifer holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin-Green Bay. She is a Registered (and Licensed) Dietitian, Certified Diabetes Care and Education Specialist, and is an active member of the American Diabetes Association and the Association of Diabetes Care and Education Specialists. She is a contributing author for DiabetesSisters and Diabetes Daily and a contributor to the Juicebox podcasts.