DM Full Guideline (2010) - VA/DoD Clinical Practice Guidelines Home

Version 4.0
VA/DoD Clinical Practice Guideline
for the Management of Diabetes Mellitus
MANAGEMENT OF DIABETES MELLITUS
Module G - Glycemic Control
G1
1
Patient with diabetes mellitus (DM)
[A]
2
Assess glycemic control
[B]
3
Determine glycemic control target by:
I . Determine recommended target
using risk stratification criteria, [C] and
II. Adjust the glycemic target according
to patient factors, [D] and
III. Set a target range after discussion
with patient [E]
4
Is patient high-risk?
[F]
Y
5
Consider referral for
comprehensive evaluation and
treatment of DM
N
6
Is patient on
medication therapy?
Y
N
7
Does patient
require insulin?
[G]
Y
8 Institute/adjust insulin
Consider referral
[H]
9
N
Assure appropriate intervention to
address patient adherence
[I]
10 Initiate/adjust therapy
[R efer to Table G2 ]
[J]
Sequential treatment for type 2 DM
11
Reinforce self management education
Consider referral for diet and DM education
See Module M
1 Life Style modification, diet and excercise
2 Monotherapy with oral agent or insulin
3 Combination (add second oral agent)
4 Insulin with daytime oral agent
5. Insulin alone
6. Referral
Continue DM management
Return to Module D
Continue on
page G2
Jan-03
Module G: Glycemic Control Page 40