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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 chart helps you track recommended diabetes
treatment frequencies and measures.

Diabetes Quick Care Guide
Download this easy-to-use reference guide to comprehensive diabetes care.

DIABETES QUICK CARE GUIDE
	ACTIVITY	FREQUENCY	GOAL / RECOMMENDATION
Health History Risk Reduction	Tobacco Use	Annual/ongoing	Document tobacco use status and assist smokers to quit.   Click here for more Refer patients to the New York State Smokers’ Quitline: 1-866-697-8487.
	Psychosocial Adjustment	Annual/ongoing	Assess for depression using evidence-based tool, like the PHQ 9.   Click for more
	Sexual Functioning	Annual/ongoing	Discuss functioning and therapy options with both male and female patients.
	Preconception	Initial/ongoing	Target A1C as close to normal (<7%) as possible and evaluate medications.   Click for more
	Self-management Care Plan	Every visit	Assess patients’ understanding of diabetes care and treatment. Set up a self-care plan and individualized goals. Follow-up to assess progress.   Click for more
Physical Exam	Blood Pressure	Every visit	<130/80.
	Weight and BMI	Every visit	Healthy weight = BMI > 18.5 and < 25. Advise weight reduction to optimize BMI.   Click for more
	Foot Exam	Every visit	Standardize foot exam forms and implement use of monofilaments.
Laboratory	A1C	Every 3-6 mos.	<7.0% (in most).
	Fasting Lipid Profile Cholesterol	Annual	LDL <100 mg/dl; HDL >40 mg/dl for men, HDL >50 mg/dl for women. Triglycerides <150 mg/dl. Pts. with overt cardiovascular disease (CVD), lower LDL to goal of <70 mg/dl.
	Urine Microalbumin/ Creatinine Ratio	Annual	Detect early kidney disease using a “spot” urine albumim-to-creatinine ratio. >30 ug alb/mg creatinine is abnormal.
	Serum Creatinine	Annual	Estimate glomerular filtration rate (GFR) to stage the level of chronic kidney disease (CKD).  Click here for more
Medication	Aspirin Therapy	Ongoing	75-162 mg/day. Consider for all pts. >40 or with additional CVD risk factors.
Immunications	ACE Inhibitor/ARB**	Ongoing	Recommend for any patient with overt CVD or patients >40 years old with one or more CVD risk factors in addition to diabetes. **ARB for patients unable to tolerate ACE.
Referrals	Flu Vaccine	Every autumn	Click for more
	Pneumovax	Once	Revaccinate pts. >65 if initial vaccine given >5 years ago and/or when pt. <65.   Click for more
	Dilated Retinal Exam	Annual	Refer to eye care professional to detect retinopathy.
	Dental Care	Every 6 mos.	Refer for dental exam.
	Diabetes Education	Annual or more often as needed	Refer to Certified Diabetes Educator (CDE) to review medications, meal planning, and self-care plan.   Find CDEs: www.diabeteseducator.org/find

 

Adapted from the New York State Diabetes Coalition