• Review glucose testing log, hypoglycemic episodes and tobacco use

•  BP goal is <130/80 mmHg

• Weigh and calculate BMI. Consider measuring waist circumference

•  Inspect skin for signs of pressure areas and breakdown

Advise, review, adjust and/or administer medications

• Glocose-lowering medications
• HTN therapy includes ACEI/ARB; diuretic type based on GFR
• ACEI/ARB for nephropathy
• Lipid-lowering drugs as needed
• Aspirin prophylaxis, age>40 or with CVD risk factors-weigh risk/benefit

• Test 4 times per year; two times per year if in good control
• General goal <7%
• Lower A1C (close to 6%) may be appropriate for individuals with a short duration of diabetes, long life expectancy and no significant CVD. as long as hypoglycemia is avoided
• Less stringent A1C goals than the general <7% may be appropriate for individuals with advanced diabetes complications, CVD, co-morbidities, reduced life span, or significant hypoglycemia

• Provide or refer: training in self-management, nutrition, physical activity
• Council on importance of regular dental exams

•  Inspect, check pulses, conduct monofilament exam

• For patients without known nephopathy, screen for microalbuminuria.  Normal<30 mcg of albumin per mg creatine
• Measure serum creatine to estimate GFR
• If nephropathy present, treat and monitor, or refer to nephrology

• Primary goal: LDL <100 mg/dl (LDL<70 mg/dl if CVD or high risk)
• Desirable: HDL >40 mg/dl, Triglycerides <150 mg/dl

• Dilated eye exam by eye care professional
• Or exam with retinal photographs read by experienced experts