DM Full Guideline (2010) - VA/DoD Clinical Practice Guidelines Home
DM Full Guideline (2010) - VA/DoD Clinical Practice Guidelines Home
DM Full Guideline (2010) - VA/DoD Clinical Practice Guidelines Home
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
Version 4.0<br />
<strong>VA</strong>/<strong>DoD</strong> <strong>Clinical</strong> <strong>Practice</strong> <strong>Guideline</strong><br />
for the Management of Diabetes Mellitus<br />
<strong>Guideline</strong> Key Elements<br />
Primary<br />
Prevention<br />
Secondary<br />
Prevention<br />
Tertiary<br />
Prevention<br />
Health<br />
Preventive<br />
Measures<br />
Patient selfmanagement<br />
&<br />
Education<br />
• Consider screening all adults (age >45) for diabetes<br />
• Encourage aerobic exercise and diet to achieve weight loss and<br />
prevent the progression of prediabetes to diabetes<br />
• Achieve individualized HbA 1c target through diet, exercise,<br />
medication, and patient self-management diabetes education<br />
• Reduce and control blood pressure to improve quality and length<br />
of life, and prevent micro- and macrovascular complications<br />
• Control cholesterol to reduce risk for cardiovascular disease<br />
• Screen periodically for kidney disease<br />
• Screen for retinopathy every 12-24 months based on ophthalmic<br />
and clinical findings<br />
• Screen annually for lower extremity complications and risk<br />
stratification<br />
• Consider aspirin therapy to reduce the risk of cardiovascular fatal<br />
events<br />
• Advise about tobacco use cessation<br />
• Provide influenza vaccination in season<br />
• Provide pneumococcal pneumonia vaccine, if indicated<br />
• Empower patients to make informed decisions about their selfcare<br />
of diabetes<br />
Introduction Page 7
Change language