Management of Type 2 Diabetes Mellitus. Ongoing Management Algorithm.

[See Glycemic Control algorithm]

[See Blood Pressure Control algorithm]

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Source: Institute for Clinical Systems Improvement (ICSI). Management of type 2 diabetes mellitus. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2006 Nov. 81 p. Management of Type 2 Diabetes Mellitus Ongoing Management Algorithm Ongoing management and follow-up of people with diabetes. A Maintain treatment goals: *Nutrition. *Exercise. *Monitor A1C every 3-6 months. -Review blood sugars at each visit. -Ask about hypoglycemia. *Monitor lipid profile yearly. *Monitor BP each visit. *Ask about ASA use. *Ask about alcohol and tobacco use. A Annual assessment of complications: A. Targeted annual history and physical exam. B. Specialist dilated eye exam. C. Renal assessment. D. Comprehensive foot exam with risk assessment. E. Cardiovascular and cerebrovascular complication assessment. F. Special considerations. A Treatment and referral for complications: A. Nephropathy. B. Neuropathy. C. Retinopathy. D. Cardiovascular and cerebrovascular disease. E. Peripheral vascular disease. A Are goals continuing to be met? Treatment goals not met: A. Modify treatment based on appropriate guidelines and / or B. See Glycemic Control and Blood Pressure Control algorithms, and / or C. Consider referral to diabetes health team or specialists. D. Assess patient adherence. E. Evaluate for depression. A A = Annotation All copyrights are reserved by the Institute for Clinical Systems Improvement, Inc.