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).