Diabetes Personal Checklist. FORM n0726 (June 2006) Tests. Exams and Physician Monitoring Place mark in month when complete. Jan Feb Mar Apr May Jun Jul …
Diabetes Personal Checklist
Year
Tests
HbA1c A1C Hemoglobin A1C LDL Bad Cholesterol HDL Good Cholesterol Blood chemistry Urine microalbumin Office visits with primary care physician Weight and Body Mass Index BMI Foot exam by health care provider Dilated eye exam Dental care and visits Check long-term blood sugar control Reduce heart and blood vessel disease risk Reduce heart and blood vessel disease risk Check kidney function Check kidney function Below 65 70 Below 100 or 70 if you smoke or have heart or blood vessel diseases Above 40 for men; over 50 for women Normal values No protein detected Blood pressure below 130/80 Lose at least 10 of excess weight; goal BMI 19-25 Normal exam No retinal damage Every 3 to 6 months
Purpose of Monitoring
Recommended Goal
Recommended Frequency
Place mark in month when complete
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Yearly Yearly Yearly Yearly
Exams and Physician Monitoring
Review health issues and Blood Pressure Reduce various risks Prevent limb injury and loss Checks blood vessels on retina Prevent gum/tooth disease Every 6 to 12 months
Every routine office visit Yearly Yearly Brush twice daily, floss daily, see dentist
every six months Once at age 50, may need repeat Yearly
Normal exam
Vaccines
Pneumonia Influenza Prevent pneumococcus infection Prevent influenza infection Reduce health risks Improve health overall Improve health overall No infection No infection
Lifestyle
Smoking status Exercise Depression No smoking Regular exercise No symptoms Every office visit 30 min daily or more Regular exercise
Recommendations for monitoring may vary from these basic guidelines Please consult with your physician Visit our PAMF Diabetes Web site at wwwpamforg/diabetes for updated diabetes services and information
FORM n0726 June 2006
Source:babyboomers-seniors.com
