DIABETES FLOW SHEET
The highlighted boxes represent the frequency, in months, that I generally recommend the listed tests and clinical examinations be performed. Please note that like most things in medicine there is no absolutely "right" way to do things and not all people with diabetes have the same requirements.
|
Test/Procedure
|
Month
|
|||||||||||
|
1
|
2
|
3
|
4
|
5
|
6
|
7
|
8
|
9
|
10
|
11
|
12
|
|
| A1C | ||||||||||||
| Fasting blood glucose | ||||||||||||
| Fasting cholesterol-total | ||||||||||||
| Fasting cholesterol-HDL | ||||||||||||
| Fasting cholesterol-LDL | ||||||||||||
| Fasting triglycerides | ||||||||||||
| Sodium | ||||||||||||
| Potassium | ||||||||||||
| Chloride | ||||||||||||
| Carbon Dioxide | ||||||||||||
| Creatinine | ||||||||||||
| Calcium | ||||||||||||
| Albumin | ||||||||||||
| Vitamin B12 | ||||||||||||
| TSH (Thyroid Stimulating Hormone) | ||||||||||||
| Complete Blood Count | ||||||||||||
| Urinalysis | ||||||||||||
| Urine albumin/creatinine ratio (urine "ACR") | ||||||||||||
| 24 hour urine protein | ||||||||||||
| 24 hour urine microalbumin | ||||||||||||
| 24 hour urine creatinine clearance | ||||||||||||
| EKG | ||||||||||||
| Blood pressure measurement | ||||||||||||
| Weight measurement | ||||||||||||
| Dilated eye examination | ||||||||||||
| Inspection of injection sites | ||||||||||||
| Inspection of feet | ||||||||||||
| Thyroid palpation | ||||||||||||
| Ankle jerk reflex testing | ||||||||||||
| Testing sensation of feet | ||||||||||||
| Influenza vaccination | ||||||||||||
* The numbers refer to general, not specific months of the year (i.e., "1" does not necessarily mean "January").
1. If you are on insulin or some oral hypoglycemic agents, fasting for more than 8 hours may not be appropriate. "Fasting blood glucose" in this table refers to a blood glucose drawn from a vein in your arm at a lab. (I recommend that most people with diabetes test their fasting blood glucose with a meter on a daily basis).
2. A twenty-four hour collection of urine is typically necessary only if you are known to have kidney problems as reflected by an elevated creatinine and/or a high urine albumin/creatinine ratio.
3. Annual EKG's are usually not necessary in young, otherwise healthy individuals.
4. Usually best done with a ten gram monofilament device (this link shows a brief animation of how we use this device...it takes a few seconds to begin).