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Diabetes Care Guidelines

To improve clinical practice for better diabetes outcomes, refer to these guidelines.

Diabetes Clinical Guideline
Download this comprehensive clinical care guideline developed by Harvard's Joslin Diabetes Center.

 

 

Diabetes Care Flowsheet
This easy-to-use chart helps you track recommended diabetes treatment frequencies and measures.

NAME: __________________________________________________ DOB: ______________________________ MEDICAL RECORD #: _________________________

DIABETES CARE FLOWSHEET
History and Physical	Frequency	Goal	DATES & RESULTS
Blood pressure	Every visit	< 130/80
Weight	Every visit	Individualize
BMI	Every visit	Individualize
Dilated retinal exam	Annually	Retinopathy prevention
Monofilament and peripheral pulses foot exam	Annually or every visit for high-risk patients	Lower extremity amputation prevention
Laboratory Analysis	Frequency	Goal
A1C	Every 3-6 months	< 7.0%
Fasting lipid profile	Annually
LDL		< 100 mg/dL
Triglycerides		< 150 mg/dL
HDL		> 40 mg/dL in men; > 50 mg/dL in women
Total		< 200 mg/dL
Urine albumin-to-creatinine ratio (spot sample)	Annually, to screen for microalbuminuria	< 30 ug alb/mg
ECG	Baseline & as clinically indicated
Vaccinations	Frequency
Influenza	Annually
Pneumococcus	Once. Revaccinate patients > 65 who received the vaccine 5 years previously & were < 65 years old.
Counseling and Risk Reduction
Smoking status: _____ Never _____ Former _____Current Quit Date: __________
Aspirin therapy (75 - 325 mg/day)
ACE Inhibition/ARB: Treatment for hypertension or microalbuminuria
Dental care (refer for annual dental care)
Sexual functioning
Depression screening
Preconception counseling and pregnancy care
Self-Management	Goals		Patient Goals (Set jointly by clinician and patient)
Physical activity	30 minutes of moderate to vigorous physical activity at least 5 days a week
Nutrition	Advise a diet of low saturated and trans fat and high fiber
Weight management	For overweight patients (BMI >25 kg/m2), advise a 10% weight reduction at a rate of 1-2 lbs/week
Self blood glucose monitoring	Teach technique, frequency and actions to take if blood sugar is too high or too low
Self foot exam	Teach technique and evaluate how the patient performs exam

 

 

 

 

Adapted from the New York City Department of Health and Mental Hygiene