Funded out Association’s general revenues and does not use industry support. Funded out Association’s general revenues and does not use industry support

Medical History (3):

History of increased blood pressure, abnormal lipids

Microvascular: retinopathy, nephropathy, and neuropathy (sensory, including history of foot lesions; autonomic, including sexual dysfunction and gastroparesis)

Macrovascular: coronary heart disease, cerebrovascular disease, and peripheral arterial disease

For women with childbearing capacity, review contraception and preconception planning

Physical Examination:

• Physical Examination:

• Height, weight, and BMI; growth and pubertal development in children and adolescents

• Blood pressure determination, including orthostatic measurements when indicated

• Fundoscopic examination

• Thyroid palpation

• Skin examination

• Comprehensive foot examination

Laboratory Evaluation

• Laboratory Evaluation

• A1C, if results not available within past 3 months

• If not performed/available within past year:

• Fasting lipid profile
• Liver function tests
• Spot urinary albumin-to-creatinine ratio
• Serum creatinine and eGFR
• Thyroid-stimulating hormone in patients with type 1 diabetes

Provide routine vaccinations for children and adults with diabetes per age-specific CDC recommendations. C

• Provide routine vaccinations for children and adults with diabetes per age-specific CDC recommendations. C

• CDC.gov/vaccines

• Administer hepatitis B vaccine to unvaccinated adults with diabetes aged 19-59 years. C

• Consider administering hepatitis B vaccine to unvaccinated adults with diabetes ≥ 60 years old. C

Consider screening patients with type 1 diabetes for autoimmune thyroid disease and celiac disease soon after diagnosis. E

• Consider screening patients with type 1 diabetes for autoimmune thyroid disease and celiac disease soon after diagnosis. E

In people with cognitive impairment/dementia, intensive glucose control cannot be expected to remediate deficits. Treatment should be tailored to avoid significant hypoglycemia. B

• In people with cognitive impairment/dementia, intensive glucose control cannot be expected to remediate deficits. Treatment should be tailored to avoid significant hypoglycemia. B

Patients with HIV should be screened for diabetes and prediabetes with a fasting glucose level every 6–12 months before starting antiretroviral therapy and 3 months after starting or changing antiretroviral therapy. E

• Patients with HIV should be screened for diabetes and prediabetes with a fasting glucose level every 6–12 months before starting antiretroviral therapy and 3 months after starting or changing antiretroviral therapy. E

• If initial screening results are normal, checking fasting glucose every year is advised. E

• If prediabetes is detected, continue to measure fasting glucose levels every 3–6 months to monitor for progression to diabetes. E

Consider screening for anxiety in people exhibiting anxiety or worries regarding diabetes complications, insulin injections or infusion, taking medications, and/or hypoglycemia that interfere with self-management behaviors. Refer for treatment if anxiety is present. B

• Consider screening for anxiety in people exhibiting anxiety or worries regarding diabetes complications, insulin injections or infusion, taking medications, and/or hypoglycemia that interfere with self-management behaviors. Refer for treatment if anxiety is present. B

• Persons with hypoglycemic unawareness, which can co-occur with fear of hypoglycemia, should be treated using blood glucose awareness training (or other evidence-based similar intervention) to help re-establish awareness of hypoglycemia and reduce fear of hypoglycemia. A

Consider annual screening with age-appropriate depression screening measures. B

• Consider annual screening with age-appropriate depression screening measures. B

• Beginning at dx of complications or when there are significant changes in medical status, consider assessment for depression. B

• Referrals for treatment of depression should be made to mental health providers with experience using evidence-based treatment approaches. A

Consider reevaluating the treatment regimen in people with diabetes who present with symptoms of disordered eating. B

• Consider reevaluating the treatment regimen in people with diabetes who present with symptoms of disordered eating. B

• Consider screening for disordered eating using validated screening measures when hyperglycemia and weight loss are unexplained based on self-reported behaviors. B

Annually screen people who are prescribed atypical antipsychotic medications for prediabetes or diabetes. B

• Annually screen people who are prescribed atypical antipsychotic medications for prediabetes or diabetes. B

• If a second-generation antipsychotic medication is prescribed, changes in weight, glycemic control, and cholesterol levels should be carefully monitored. C

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