EVERY 3 to 6 MONTHS
Glycemic Control Guidelines:
~ Fasting or pre-meal glucose level 4-7 mmol/L; 1-2 hours after meal 5-10 mmol/L
PROCEDURE: Review Blood Glucose Records and record when done.

~ Every 3-6 months: Target <0.070 (<115% of upper limit of normal)
PROCEDURE: HgbA1c

~ PROCEDURE: Hypoglycemia (indicate frequency).

Hypertension Guidelines:
~ Goal <=130/80 (Goal for patients with overt nephropathy <=125/75)
PROCEDURE: BP and BP medications.

Other Guidelines:
~ Goal body mass index (BMI) <25
PROCEDURE: Weight/BMI

~ Foot Care
PROCEDURE: Lower extremity exam and record when done.

~ Reinforce lifestyle counseling
PROCEDURE: Smoking, activity, diet, stress and record when done.

ANNUALLY and/or AS INDICATED
Lipids: Fasting Lipid Profile for patient's >=30 years of age
Goal: <4.0 ~ PROCEDURE: Total Chol
Goal: <2.5 ~ PROCEDURE: LDL
Goal: >1.0 ~ PROCEDURE: HDL
Goal: <2.0 ~ PROCEDURE: Triglycerides
Goal: <4.0 ~ PROCEDURE: Ratio (Total Chol/HDL)
PROCEDURE: Lipid Lowering Meds and record.

Meter: within 15% of simultaneous Lab Value
PROCEDURE: Fasting Glucose Meter/Lab Comparison

Renal: Screen for Nephropathy...
Type 1: Annually >15 years old and 5 year history of DM
PROCEDURE: Microalbumin screen (albumin: creatinine ratio) (MAUR) <3.5 mg/mmol

Type 2: At diagnosis, then annually
PROCEDURE: 24 hour microalbumin as indicated

Eyes: Dilated eye exam:
Type 1: Annually >25 years old and 5 year history of DM
Type 2: At diagnosis, then as indicated, min. q 2 years
PROCEDURE: Ophthalmologist/Optometrist for dilated eye exam.

Neuropathy: Test for loss of sensation with 10g monofilament under the great toe, the small toe and at an equal distance between. Record reponses.
PROCEDURE: Sensory testing.

Education: People with diabetes need the support of an interdisciplinary team of health and other professionals.
PROCEDURE: Diabetes/Lipids Education.

Annual Influenza Vaccine:
PROCEDURE: record date.

Once Lifetime Pneumococcal Vaccine:
PROCEDURE: record date.

See clinical progress notes:
PROCEDURE: record if applicable.