Full Clinical Guidelines - Community First Health Plans.

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Reviews/Important Articles: Abraira C, Colwell J, Nuttall F, et al. Cardiovascular events and correlates in the Veterans Affairs Diabetes Feasibility Trial. Veterans Affairs Cooperative Study on Glycemic Control and Complications in Type II Diabetes. Arch Intern Med. 1997;157(2):181-8. Anonymous. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998;352(9131):837-53. DeWitt DE, Dugdale DC. Using new insulin strategies in the outpatient treatment of diabetes: clinical applications. JAMA. 2003;289(17):2265-9. DeWitt DE, Hirsch IB. Outpatient insulin therapy in type 1 and type 2 diabetes mellitus: scientific review. JAMA. 2003;289(17):2254-64. Implementation Conference for ACE Outpatient Diabetes Mellitus Consensus Conference Recommendations: Position Statement, February 2, 2005. Available online at http://www.aace.com/pub/odimplementation/PositionStatement.pdf. Accessed on May 2, 2005. Hirsch IB. Insulin analogues. N Engl J Med. 2005;352(2):174-83. ONCE DAILY INSULIN Morning vs. Bedtime NPH Groop LC, Widen E, Ekstrand A, et al. Morning or bedtime NPH insulin combined with sulfonylurea in treatment of NIDDM. Diabetes Care. 1992;15(7):831-4. Morning vs. Bedtime Glargine Fritsche A, Schweitzer MA, Haring HU. Glimepiride combined with morning insulin glargine, bedtime neutral protamine hagedorn insulin, or bedtime insulin glargine in patients with type 2 diabetes. A randomized, controlled trial. Ann Intern Med. 2003;138(12):952-9. NPH vs. Glargine Riddle MC, Rosenstock J, Gerich J. The treat-to-target trial: randomized addition of glargine or human NPH insulin to oral therapy of type 2 diabetic patients. Diabetes Care. 2003;26(11):3080-6. ONCE DAILY vs. TWICE DAILY REGIMEN Raskin P, Allen E, Hollander P, et al. Initiating insulin therapy in type 2 Diabetes: a comparison of biphasic and basal insulin analogs. Diabetes Care. 2005;28(2):260-5. MULTIPLE DOSE INSULIN REGIMENS 2-shot regimens NPH/Regular vs. NPH/ short acting analogue therapy Vignati L, Anderson JH Jr, Iversen PW. Efficacy of insulin lispro in combination with NPH human insulin twice per day in patients with insulin-dependent or noninsulin-dependent diabetes mellitus. Multicenter Insulin LisproStudy Group. Clin Ther. 1997;19(6):1408-21. Revised 10-20-05 2-shot regimens (continued) 70% NPH/ 30% Regular vs. Humalog Mix 75/25 TM or Novolog Mix 70/30 TM Roach P, Yue L, Arora V. Improved postprandial glycemic control during treatment with Humalog Mix25, a novel protamine-based insulin lispro formulation. Humalog Mix25 Study Group. Diabetes Care. 1999;22(8):1258-61. Boehm BO, Home PD, Behrend C, et al. Premixed insulin aspart 30 vs. premixed human insulin 30/70 twice daily: a randomized trial in Type 1 and Type 2 diabetic patients. Diabet Med. 2002;19(5):393-9. 3-shot Regimens Ohkubo Y, Kishikawa H, Araki E, et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Res Clin Pract. 1995;28(2):103-17. Intensive Insulin Therapy Ohkubo Y, Kishikawa H, Araki E, et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Res Clin Pract. 1995;28(2):103-17. Saudek CD, Duckworth WC, Giobbie-Hurder A, et al. Implantable insulin pump vs multiple-dose insulin for non-insulin-dependent diabetes mellitus: a randomized clinical trial. Department of Veterans Affairs Implantable Insulin Pump Study Group. JAMA. 1996;276(16):1322-7. Raskin P, Bode BW, Marks JB, et al. Continuous subcutaneous insulin infusion and multiple daily injection therapy are equally effective in type 2 diabetes: a randomized, parallel-group, 24-week study. Diabetes Care. 2003;26(9):2598-603. Bretzel RG, Arnolds S, Medding J, et al. A direct efficacy and safety comparison of insulin aspart, human soluble insulin, and human premix insulin (70/30) in patients with type 2 diabetes. Diabetes Care. 2004;27(5):1023-7. (Page 6 of 6) 52 H EALTH PLANS www.cfhp.com
Publication # 45-11266 Age 126 mg/dL Consider ETT 1 Prior to Prescription Low intensity/Low impact activity 2 Low intensity/Low impact activity 2, 3 Low intensity/Low impact activity 2 ETT is recommended prior to moderate or vigorous activity 1 If your patients are “apparently healthy” and have fewer than two major risk factors for cardiovascular disease (CVD), then they are categorized by age. • For men and women under 35 yrs. of age, there are no limitations. They can safely begin or continue a program of moderate or vigorous activity. • If they exceed the age limit (≥35 yrs.), it is safe to limit your recommendations to moderate activity (55% to 70% maximum heart rate) for both genders. Patients in this group who wish to participate in vigorous or competitive activities should be considered for an ETT screening. If your patients have one or more major risk factors for cardiovascular disease, they should undergo an ETT before beginning a moderate exercise program. It is important to underscore the fact that the majority of your patients, regardless of risk factors, can and should be encouraged to start or continue a program of regular moderate physical activity. Revised 01-22-04 9.5 Exercise Algorithm Type 2 Diabetes Prevention and Therapy H EALTH PLANS www.cfhp.com 53
Page 1 and 2: Community First Health Plans Qualit
Page 3 and 4: 10.5 ATP III Classification of Chol
Page 5 and 6: Such information is released only t
Page 7 and 8: Non Voting • Martin Jimenez, Dire
Page 9 and 10: The purpose of these guidelines is
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Page 13 and 14: Recommended Adult Immunization Sche
Page 15 and 16: Footnotes — Recommended Adult Imm
Page 17 and 18: CFHP has adopted the National Asthm
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Page 21 and 22: Managing Asthma Long Term 41 FIGURE
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Page 29 and 30: II. Some hyperactive-impulsive or i
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Page 33 and 34: Criteria Requirements 33. Release o
Page 35 and 36: The evaluation of breast disease is
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Page 45 and 46: GLYCEMIC CONTROL BIBLIOGRAPHY • R
Page 47 and 48: Publication # 45-11647 Targets* A1
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Page 73 and 74: Revised 10-25-07 IV INSULIN INFUSIO
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Page 77 and 78: Revised 2-21-08 Publication #: E45-
Page 79 and 80: Abbreviations AGI Alpha-Glucosidase
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CFHP PCP MEDICAL RECORD REVIEW TOOL
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13.3 Specialist Medical Record Docu
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13.4 Specialist Medical Record Revi
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Risk Factors for Osteoporosis Fract
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It is well documented that obesity
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CLASSIFICATION OF OVERWEIGHT AND OB
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16.1.1 Preventive Pediatric Health
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TEXAS MEDICAID PROVIDER PROCEDURES
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CHILDREN’S SERVICES HANDBOOK P h
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CHILDREN’S SERVICES HANDBOOK P R
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FIGURE 2: Recommended immunization
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Comprehensive antepartum care is vi
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The following variables should be e
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CRITERIA 19. Unresolved Problems Fr
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CFHP OB/GYN SPECIALTY MEDICAL RECOR
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CFHP OB/GYN SPECIALTY MEDICAL RECOR
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According to the National Institute
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. aminotransferase (AST) and alanin
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PREVENTION RECOMMENDATIONS 1. The E
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2 to 20 years: Boys Body mass index
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AsthmaMatters is an initiative deve
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According to the Centers for Diseas
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