Madison (WI): Wisconsin Diabetes Prevention and Control Program; 2004. Diabetes-focused visit including assessment of physical activity, weight, body …
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Complete Summary
GUIDELINE TITLE
Wisconsin essential diabetes mellitus care guidelines
BIBLIOGRAPHIC SOURCES
Wisconsin Diabetes Advisory Group Wisconsin essential diabetes mellitus
care guidelines Madison WI: Wisconsin Diabetes Prevention and Control
Program; 2004 Various p [246 references]
GUIDELINE STATUS
Note: This guideline has been updated The National Guideline
Clearinghouse NGC is working to update this summary
COMPLETE SUMMARY CONTENT
SCOPE
METHODOLOGY - including Rating Scheme and Cost Analysis
RECOMMENDATIONS
EVIDENCE SUPPORTING THE RECOMMENDATIONS
BENEFITS/HARMS OF IMPLEMENTING THE GUIDELINE RECOMMENDATIONS
CONTRAINDICATIONS
QUALIFYING STATEMENTS
IMPLEMENTATION OF THE GUIDELINE
INSTITUTE OF MEDICINE IOM NATIONAL HEALTHCARE QUALITY REPORT CATEGORIES
IDENTIFYING INFORMATION AND AVAILABILITY
DISCLAIMER
SCOPE
DISEASE/CONDITIONS
Pre-diabetes
Diabetes mellitus type 1, type 2, gestational
Diabetes-related complications
GUIDELINE CATEGORY
Diagnosis
Evaluation
Management
Prevention
Risk Assessment
Screening
CLINICAL SPECIALTY
Cardiology
Dentistry
Dermatology
Emergency Medicine
Endocrinology
Family Practice
Gastroenterology
Geriatrics
Infectious Diseases
Internal Medicine
Nephrology
Neurology
Nursing
Nutrition
Obstetrics and Gynecology
Ophthalmology
Optometry
Pediatrics
Pharmacology
Physical Medicine and Rehabilitation
Podiatry
Preventive Medicine
Psychiatry
Psychology
Urology
INTENDED USERS
Advanced Practice Nurses
Allied Health Personnel
Dentists
Dietitians
Emergency Medical Technicians/Paramedics
Health Care Providers
Hospitals
Managed Care Organizations
Nurses
Pharmacists
Physical Therapists
Physician Assistants
Physicians
Podiatrists
Psychologists/Non-physician Behavioral Health Clinicians
Public Health Departments
Social Workers
Students
GUIDELINE OBJECTIVES
To provide recommendations, which serves as a guide for the management
of diabetes mellitus
To provide a concise, general framework for the care and prevention of
diabetes-related complications
To improve care and enhance quality of life for people with diabetes
TARGET POPULATION
Patients
with type 1 and type 2 diabetes mellitus, pre-diabetes, pre-
gestational, or gestational diabetes
INTERVENTIONS AND PRACTICES CONSIDERED
General Care
1 Diabetes-focused visit including assessment of physical activity,
weight, body mass index BMI, growth, and review of management plan
2 Self-management education
3 Medical nutrition therapy
4 Glycemic control including:
A1c testing
Review of self-monitoring of blood glucose SMBC
Review of medication management monitoring, side effects, and
hypoglycemic episodes
Glucose-lowering agents alone or in combination with one or more
oral agents and/or insulin
5 Referral to specialists, as appropriate
6 Essential patient education
Cardiovascular Care
1 Lifestyle modification
2 Tobacco cessation
3 Lipid and blood pressure monitoring and therapy, including aspirin
prophylaxis, unless contraindicated
Kidney Care
1 Obtain albumin/creatinine ratio, serum creatinine, and routine
urinalysis, as appropriate
2 Angiotensin-converting enzyme ACE inhibitors or Angiotensin receptor
blockers ARB and aggressive blood pressure
therapy
Eye Care
1 Dilated eye exams
Foot Care
1 Routine and comprehensive foot exams
2 Risk categorization
Oral Care
1 Oral screening
2 Dental exam
Emotional/Sexual Health Care
1 Depression screening and recommendations
2 Assess sexual health concerns
Influenza and Pneumococcal Immunizations
1 Provide influenza and pneumococcal immunizations
Preconception and Pregnancy Care
1 Provide preconception counseling
2 Assess contraception/discuss family panning
3 Screen for gestational diabetes
Screening for Pre-diabetes and Diabetes
1 Fasting plasma glucose or oral glucose tolerance test
MAJOR OUTCOMES CONSIDERED
Efficacy of management strategies at preventing, delaying, or reducing
the risk of diabetes-related complications
Glycemic control
Quality of life
Cost-effectiveness of care
METHODOLOGY
METHODS USED TO COLLECT/SELECT EVIDENCE
Hand-searches of Published Literature Primary Sources
Hand-searches of Published Literature Secondary Sources
Searches of Electronic Databases
DESCRIPTION OF METHODS USED TO COLLECT/SELECT THE EVIDENCE
Not stated
NUMBER OF SOURCE
DOCUMENTS
Not stated
METHODS USED TO ASSESS THE QUALITY AND STRENGTH OF THE EVIDENCE
Expert Consensus
Expert Consensus Committee
Subjective Review
RATING SCHEME FOR THE STRENGTH OF THE EVIDENCE
Not applicable
METHODS USED TO ANALYZE THE EVIDENCE
Review of Published Meta-Analyses
Systematic Review
DESCRIPTION OF THE METHODS USED TO ANALYZE THE EVIDENCE
Not stated
METHODS USED TO FORMULATE THE RECOMMENDATIONS
Expert Consensus
Informal Consensus
DESCRIPTION OF METHODS USED TO FORMULATE THE RECOMMENDATIONS
Not stated
RATING SCHEME FOR THE STRENGTH OF THE RECOMMENDATIONS
Not applicable
COST ANALYSIS
Published cost analyses were reviewed and reported, not determined by the
guideline developer
Good glycemic control is cost-effective and improves quality of life It
is estimated that for every one percent decrease in A1c, there is a 14-
20 decrease in hospitalizations, resulting in 4-5 billion savings in
direct health care costs alone
Screening for, and treatment of, diabetic kidney disease adds years to
life and is proven to be cost-effective
METHOD OF GUIDELINE VALIDATION
Comparison with Guidelines from Other Groups
External Peer Review
Internal Peer Review
DESCRIPTION OF METHOD OF GUIDELINE VALIDATION
The authors of these Guidelines, the Wisconsin Diabetes Advisory Group,
and many other individuals were involved in the review and revision of
various drafts and the final document
RECOMMENDATIONS
MAJOR RECOMMENDATIONS
Note: This guideline has been updated The National Guideline
Clearinghouse NGC is working to update this summary The
recommendations that follow are based on the previous version of the
guideline
General Recommendations/Care
Perform diabetes-focused visit
Frequency
Type 1: Every 3 months
Type 2: Every 3-6 months
Consider more often if A1c 70 and/or complications exist
Review management plan, assess problems and goals
Frequency
Each focused visit; revise as needed
Assess physical activity
Frequency
Each focused visit
Assess nutrition/weight/body mass index BMI/growth
Frequency
Each focused visit
Self-Management Education
Refer to diabetes educator, preferably a certified diabetes educator
CDE; curriculum to
include the ten key areas of the national
standards for diabetes self-management education
Frequency
At diagnosis, then every 6-12 months, or more as needed
Medical Nutrition Therapy
Refer to registered dietician, preferably a certified diabetes
educator; to include areas defined by the American Dietetic
Associations Nutrition Practice Guidelines
Frequency
Type 1: At diagnosis; then, if age 18, every 3-6 months; if age
18, every 6-12 months
Type 2: At diagnosis; then every 6-12 months or more as needed
Glycemic Control
Check A1c see Algorithm 1 in original guideline document
Goal: 70 or 1 above lab norms
Frequency
Type 1: Every 3 months
Type 2: Every 3-6 months
Review goals, medications, side effects, and frequency of hypoglycemia
Frequency
Each focused visit
Assess self-blood glucose monitoring schedule
Frequency
Each focused visit, 2-4 times/day, or as recommended
Cardiovascular Care
Check lipid profile
Adult goals: Total Cholesterol 200 mg/dL
Triglycerides 150 milligramsmg/dL
High-density
lipoprotein HDL 40 mg/dL men
HDL 50 mg/dL women
Non-HDL Cholesterol 130 mg/dL
Low-density lipoprotein LDL 100 mg/dL optimal goal
Low-density lipoprotein 70 mg/dL for very high risk
Frequency
Children: If 2 years, after diagnosis and once glycemic control
is established Repeat annually if abnormal Follow National
Cholesterol Education Program NCEP III guidelines
Adults: Annually If abnormal, follow NCEP III guidelines
Blood pressure
Adult goal: 130/80 mmHg
Pediatric goal: below 90 of ideal for age
Frequency
Each focused visit
Assess smoking status
Frequency
Each visit; if smoker, counsel to stop; refer to cessation
Start aspirin prophylaxis unless contraindicated
Frequency
Age 40 with diabetes; Age 40, individualize based on risk
Kidney Care
Check albumin/creatinine ratio using a random urine sample, also
called urine microalbumin/creatinine ratio see Algorithm 2 in the
original guideline document
Frequency
Type 1: Begin with puberty or after 5 years duration, then
annually
Type 2:
At diagnosis, then annually
Check serum creatinine
Frequency
At diagnosis, then annually
Perform routine urinalysis
Frequency
At diagnosis, then as indicated
Eye Care
Perform dilated eye exam by an ophthalmologist or optometrist
Frequency
Type 1: If age 10, within 3-5 years of onset, then annually
Type 2: At diagnosis, then annually; two exceptions exist see
Section 7 in the original guideline document
Foot Care
Inspect feet, with shoes and socks off
Frequency
Each focused visit; stress need for daily self-exam
Perform comprehensive lower extremity exam
Frequency
Annually, with monofilament
Oral Care
Perform oral health screening
Frequency
At diagnosis, then each focused visit
Advise dental exam by general dentist or periodontal specialist
Frequency
At diagnosis, then every 6 months if dentate and every 12
months if edentate
Emotional/Sexual Health Care
Assess emotional health; screen for depression
Frequency
Each focused visit
Assess sexual health concerns
Frequency
Each focused visit
Immunizations
Provide influenza vaccine
Frequency
Annually, if age 6 months
Provide pneumococcal vaccine
Frequency
Once; then per Advisory Committee on Immunization Practices
Preconception and Pregnancy Care
Provide preconception counseling/assessment
Frequency
3-4 months prior to conception
Assess contraception/discuss family planning
Frequency
At diagnosis and each focused visit
Screen for gestational diabetes
Frequency
At 24-28 weeks gestation or sooner if high risk
Consider referring to provider experienced in care of diabetic
women during pregnancy
Screening for Pre-diabetes and Diabetes
Perform fasting plasma glucose test or oral glucose tolerance test
see Algorithm 6 in the original guideline document
Frequency
Test all people age 45; if normal and person has no risk
factors, retest in 3 years
Screening for Pre-diabetes and Diabetes
Test all people 45 years for pre-diabetes and diabetes If screening
results are normal and person has no risk factors, re-testing
should
occur at 3-year intervals Screen at a younger age or more often if the
person has one or more risk factors from the following list:
1 Body mass index 25 kilograms/m2
2 Sedentary lifestyle
3 Prior history of pre-diabetes/glucose intolerance
4 Race/ethnicity eg, African-Americans, Hispanic-Americans, Native
Americans, Asian-Americans, and Pacific Islanders
5 Family history of diabetes in one or more first-degree relatives
6 History of hypertension 140/90 mmHg
7 History of vascular disease
8 History of dyslipidemia: HDL 35 mg/dL and/or a triglyceride level
250 mg/dL
9 Markers of insulin resistance: eg, acanthosis nigricans and/or
waist circumference 40 inches in men and 35 inches in women
10 History of polycystic ovary syndrome PCOS
11 History of gestational diabetes mellitus GDM in women or delivery of
a baby weighing more than nine pounds at birth
Diagnosis of Pre-diabetes and Diabetes 2004 Criteria
Fasting Plasma Glucose FPG
How Performed: Blood glucose is measured after at least an 8 hour fast
Normal: 100 mg/dL
Pre-diabetes impaired fasting glucose [IFG]: 100-125 mg/dL
Diabetes Mellitus: 126 mg/dL
Oral
Glucose Tolerance Test OGTT
How Performed: 75-gram glucose load drink is ingested after at least an
8-hour fast; blood glucose is measured at 2 hours
Normal: 140 mg/dL
Pre-diabetes impaired glucose tolerance [IGT]: 140-199 mg/dL
Diabetes Mellitus: 200 mg/dL
Random/Casual Plasma Glucose with symptoms
How Performed: Blood glucose is measured at any time regardless of eating
Diabetes Mellitus: 200 mg/dL with symptoms
Test must be confirmed by repeating on a different day
It is not appropriate to have a person eat a meal and then draw a
random glucose two hours after
CLINICAL ALGORITHMS
Clinical algorithms are provided in the original guideline document for:
Type 2 Diabetes: Glycemic Control
Screening and Initial Recommendations for Diabetic Kidney Disease
Microalbuminuria and Macroalbuminuria
Diabetic Foot Disorders ULCER: A Clinical Practice Pathway
Diabetic Foot Disorders INFECTION: A Clinical Practice Pathway
Diabetic Foot Disorders CHARCOT FOOT: A Clinical Practice Pathway
Screening for Pre-diabetes and Diabetes
EVIDENCE SUPPORTING THE RECOMMENDATIONS
TYPE OF EVIDENCE SUPPORTING THE
RECOMMENDATIONS
The recommendations are based on results of clinical trials, accepted
science, and expert opinions
BENEFITS/HARMS OF IMPLEMENTING THE GUIDELINE RECOMMENDATIONS
POTENTIAL BENEFITS
Overall Potential Benefits
Prevention, early detection, and aggressive treatment can have a
significant impact on the quality of life for people with diabetes
The management goal for diabetes is to achieve optimal glycemic
control to prevent acute and chronic complications
Specific Potential Benefits
Self-Management Education
The primary goal of diabetes self-management education DSME is to
provide knowledge and skill training, facilitate problem solving, help
people identify barriers to change, and nurture the development of coping
skills with the goal of achieving effective self-management and behavior
change
Medical Nutrition Therapy
Early intervention and follow-up of medical nutrition therapy MNT are
essential to achieve and maintain glycemic control and reduce the risk of
cardiovascular disease and other complications As the sole therapy, or
in conjunction with other therapies, MNT can help prevent and/or delay
the
onset or progression of costly diabetes-related complications and
hospitalizations
Glycemic Control
Good glycemic control is cost-effective and improves quality of life It
is estimated that for every one percent decrease in A1c, there is a 14-
20 decrease in hospitalizations, resulting in 4-5 billion savings in
direct health care costs alone
Cardiovascular Care
Aggressive assessment and treatment of cardiovascular disease may prevent
or decrease the development of cardiovascular complications
Kidney Care
Early detection and intervention of diabetic kidney disease, along with
improved glycemic and blood pressure control, can help reduce the risk of
the development and progression of nephropathy Screening for, and
treatment of, diabetic kidney disease adds years to life and is proven to
be cost-effective
Eye Care
Studies have shown that early detection and proper treatment of diabetic
eye disease can reduce the risk of diabetic retinopathy and blindness by
50-60 In addition, proper glycemic control can reduce the risk of
progression of retinopathy by 34-76 For each two percent decrease in
A1c, there is a 50-75 reduction in complications Not
only do diabetic
retinopathy screening and treatment programs result in increased years of
sight, but they are clearly also cost-saving interventions
Foot Care
Simple prevention strategies may reduce the rate of lower extremity
complications in people with diabetes
Oral Care
The negative outcomes of periodontitis can be avoided through appropriate
screening and timely referral and treatment
Emotional/Sexual Health Care
Early recognition of depression symptoms, prompt treatment, and referral
may lead to improved diabetes self-care and quality of life
Influenza and Pneumococcal Immunizations
Immunizations can prevent serious illness, complications,
hospitalizations, and death associated with influenza and pneumococcal
disease
Preconception and Pregnancy Care
Preconception counseling, intensive management to optimize glycemic
control before pregnancy and during pregnancy, and utilizing a team of
providers experienced in caring for women with diabetes may help these at
risk women achieve health outcomes similar to those of women without
diabetes
Screening for Pre-diabetes and Diabetes
Evidence from studies have shown supportive education
for medical
nutritional therapy and self-management after the diagnosis of pre-
diabetes are effective in slowing and even preventing the progression to
Type 2 diabetes
POTENTIAL HARMS
For information on side effects of diabetes medications, see Diabetes
medications update - 2004 at the end of Section 4 in the original
guideline document
CONTRAINDICATIONS
CONTRAINDICATIONS
For information on contraindications to common diabetes medications, see
Diabetes medications update - 2004 at the end of Section 4 in the
original guideline document
QUALIFYING STATEMENTS
QUALIFYING STATEMENTS
The Guidelines are population-based and therefore intended to be
appropriate for most people with diabetes, but not intended to define
the optimal level of care that an individual person may need Clinical
judgment may indicate the need for adjustments appropriate to the
needs of each particular person eg, age, medical condition, or
individual glycemic control goal
The recommendations in these Essential Diabetes Mellitus Care
Guidelines are intended to serve as a guide for
clinicians and others
involved in the implementation of care and preventive services for
people with diabetes They are not intended to replace or preclude
clinical judgement Abnormal physical or lab findings should result in
follow-up/intervention
IMPLEMENTATION OF THE GUIDELINE
DESCRIPTION OF IMPLEMENTATION STRATEGY
Phase 1
Wisconsin healthcare professionals were invited to attend one of the 11
programs offered around the state of Wisconsin These free workshops,
that featured a healthy breakfast and continuing education credits,
educated the professionals about the newly updated Wisconsin Essential
Diabetes Mellitus Care Guidelines
Community members were invited to one of the 11 free evening programs
held around the state, featuring healthy snacks, to learn about the newly
updated Wisconsin Essential Diabetes Mellitus Care Guidelines
Phase 2
In response to multiple requests to provide Phase 1 in many more
locations across the state, the Wisconsin Essential Diabetes Mellitus
Care Guidelines Training Project CDs were designed by health systems to
implement successful health professional and/or community
training on the
Wisconsin Essential Diabetes Mellitus Care Guidelines
IMPLEMENTATION TOOLS
Audit Criteria/Indicators
Chart Documentation/Checklists/Forms
Clinical Algorithm
Foreign Language Translations
Patient Resources
Quality Measures
Quick Reference Guides/Physician Guides
Resources
Slide Presentation
Wall Poster
For information about availability, see the Availability of Companion
Documents and Patient Resources fields below
INSTITUTE OF MEDICINE IOM NATIONAL HEALTHCARE QUALITY REPORT CATEGORIES
IOM CARE NEED
Living with Illness
Staying Healthy
IOM DOMAIN
Effectiveness
Patient-centeredness
IDENTIFYING INFORMATION AND AVAILABILITY
BIBLIOGRAPHIC SOURCES
Wisconsin Diabetes Advisory Group Wisconsin essential diabetes mellitus
care guidelines Madison WI: Wisconsin Diabetes Prevention and Control
Program; 2004 Various p [246 references]
ADAPTATION
Not applicable: The guideline was not adapted from another source
DATE RELEASED
2004 Dec
GUIDELINE DEVELOPERS
Wisconsin Diabetes Prevention and Control Program - State/Local
Government Agency [US]
SOURCES OF FUNDING
Centers for Disease Control
and Prevention CDC, Division of Diabetes
Translation
GUIDELINE COMMITTEE
Guidelines Work Groups and Diabetes Advisory Group
COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE
Workgroup Members: Mary Anderson, Wisconsin Association for Perinatal
Care, Preconception and Prenatal Care Committee; Ruth Ann Berkholtz,
MSSW, BCD, Licensed Clinical Social Worker, Madison Psychiatric
Associates; Dory Blobner, RN, MS, CDE, Diabetes Education Coordinator,
Dean Clinic; Mary Bruskewitz, RN, MS, Wisconsin Nurses Association,
Capitol Area and Surrounding Communities Association of Diabetes
Educators CASCADE; Jenny Camponeschi, MS, Diabetes Prevention and
Control Program, Wisconsin Department of Health and Family Services; Pat
Celek, RN, CDE, Aurora Health Care; Ann Conway, RN, MS, MPA, Executive
Director, Wisconsin Association for Perinatal Care; Susan Davidson, MD,
St Marys Hospital; Sarah Dillenbeck, RD, CD, CDE, UW Medical
Foundation; Robert Draeger, Retired Teacher; Sherree Drezner, ACSW, LCSW,
University of Wisconsin Hospital and Clinics; Krista Eastman, BA,
Consultant; April Eddy, RN, CNS, CDE, Meriter Hospital, Perinatal Clinic;
Ann Ebert, PharmD,
Wisconsin Association for Perinatal Care,
Preconception and Prenatal Care Committee; Diane Elson, MD, University of
Wisconsin Hospital and Clinics; Joan Fisher, RN, CCM, MercyCare Insurance
Company; Irene Golembiewski, MA, Media Solutions, University of Wisconsin
Medical School; Margo Grady, MS, CGC, Wisconsin Association for Perinatal
Care, Chair, Preconception and Prenatal Care Committee Meriter Hospital;
Rosalyn Haase, RD/CD, CDE, MPH, BC-ADM, Wisconsin Dietetic Association;
Peter G Hanson, MD, Peter Christiansen Health Center; Dee Helgeson, RN,
CDE, Reedsburg Physicians Group; Sonja Henry, MS, CGC, Wisconsin
Association for Perinatal Care, Preconception and Prenatal Care
Committee; Dan Hopfensperger, Immunization Program, Wisconsin Department
of Health and Family Services; Sue Hugl, RN, BSN, CDE, Froedtert and
Medical College Diabetes Care Center; Anthony M Iacopino, DMD, PhD,
Wisconsin Dental Association, Marquette University School of Dentistry;
Jonathan B Jaffery, MD, University of Wisconsin Medical School,
Department of Medicine, Section of Nephrology; Kate Jaeger, Diabetes
Program Assistant, Sixteenth Street Community Health Center; Mary
Jenny,
RN, BSN, Population Health Care Coordinator, WEA Trust; Audrey Johnson,
RN, MSN, CDE, Aurora Health Care; Virginia Jordan, MS, RD, CDE, West
Central Wisconsin Association of Diabetes Educators WECWAADE; Pamela
Kittleson, RPh, UW Medical Foundation; Kevin P Kortsch, DPM, Wisconsin
Society of Podiatric Medicine; Christy Kreul, Physicians Plus Insurance
Corporation; Leah Ludlum, RN, BSN, CDE, Diabetes Prevention and Control
Program, Wisconsin Department of Health and Family Services; Steven B
Magill, MD, PhD, St Lukes Medical Center, Aurora Health Care; Glenna
McWilliams, Board Certified Pedorthist, National Pedorthic Services,
Inc; Melissa Meredith, MD, University of Wisconsin Hospital and Clinics;
Kristi Michalowski, MS, CPHQ, MetaStar, Inc; Kyle Mounts, MD,
Neonatologist, Newborn Care Physicians of Southeast Wisconsin; Jane
Nelson Worel, RN, MS, University of Wisconsin Hospital and Clinics,
Preventive Cardiology Program; Paul M Reber, DO, Dean Medical Center;
Chandra Reddy, MD, MPH, Great Lakes Inter-Tribal Council, Inc; Thomas
Repas, MD, Affinity Medical Group, Department of Endocrinology; Tim
Ringhand, RN, MPH, Diabetes Prevention and
Control Program, Wisconsin
Department of Health and Family Services; Fredric J Romm, MD, MPH,
Medical College of Wisconsin; Elaine Rosenblatt, NP, University of
Wisconsin Hospital and Clinics; David A Scheidt, OD, Wisconsin
Optometric Association; Eva Scheppa, RN, BSN, Family Health Center of
Marshfield, Marshfield Clinic; Julie Schuller, MD, MPH, Medical Director,
Sixteenth Street Community Health Center; Elizabeth Spencer, RD, MS, CDE,
UW Health Eau Claire Family Medicine Clinic, University of Wisconsin,
Department of Family Medicine; Thomas S Stevens, MD, Wisconsin Academy
of Ophthalmology; Alisa Sunness, RD, CDE, UW Medical Foundation; Julie
Thiel, RPh, Pharmacy Society of Wisconsin; Gail Underbakke, MS, RD,
University of Wisconsin Hospital and Clinics, Preventive Cardiology
Program, University of Wisconsin Medical Foundation, Behavioral Health
Consultation Services; William Weis, DPM, FACFAS, DWS, Wisconsin Society
of Podiatric Medicine; Jennifer Wilen, MPH, Learning Coordinator,
Wisconsin Association for Perinatal Care; Susan Williams, RN, CDE, Nurse
Diabetes Educator, St Francis Hospital; Kara Yaeger, RN, CDE, University
of Wisconsin
Hospital and Clinics
FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST
Not stated
GUIDELINE STATUS
Note: This guideline has been updated The National Guideline
Clearinghouse NGC is working to update this summary
GUIDELINE AVAILABILITY
Electronic copies of the updated guideline: Available from the Wisconsin
Diabetes Prevention and Control Program Web site
Print copies: Available from the Wisconsin Diabetes Prevention and
Control Program, Bureau of Community Health Promotion, PO Box 2659,
Madison, WI 53701-2659
AVAILABILITY OF COMPANION DOCUMENTS
The following are available:
Wisconsin diabetes strategic plan 2004-2009 Madison WI: Wisconsin
Diabetes Advisory Group Department of Health and Family Services,
Division of Public Health, Diabetes Prevention and Control Program
2004 Oct
Making a difference: essential diabetes care in Wisconsin 2005
Webcast 2005
Diabetes self-management information and record booklet and wallet
card English and Spanish
Diabetes Advisory Group Diabetes guidelines professional presentation
2005 Madison WI: Wisconsin Diabetes Prevention and Control Program
2005
Electronic
copies: Available from the Wisconsin Diabetes Prevention and
Control Program Web site
Additionally, the Wisconsin Diabetes Advisory Group has made available a
variety of implementation tools included in the original guideline
document:
Body mass index BMI tables for adults
Growth charts for children
Diabetes self-management education records
Diabetes patient flow sheet/chart audit tools
Diabetes sick day plan
Diabetes eye exam consultation form
Annual comprehensive diabetes foot exam form
Office poster available in English, Spanish, and Hmong
High-risk foot stickers for patient record
Diabetes dental referral form
Patient Health Questionnaire PHQ-9
Diabetes population-based indicators
Personal diabetes care record cards available in English, Spanish,
and Hmong
Electronic copies: Available in the original guideline document and from
the Resources section of the Wisconsin Diabetes Prevention and Control
Program Web site
PATIENT RESOURCES
The following is available:
Diabetes self-management information and record booklet Madison WI:
Wisconsin Diabetes Advisory Group Department of
Health and Family
Services, Division of Public Health, Diabetes Prevention and Control
Program
Electronic copies: Available from the Wisconsin Diabetes Prevention and
Control Program Web site
Print copies: Available from the Wisconsin Diabetes Prevention and
Control Program, Bureau of Community Health Promotion, PO Box 2659,
Madison, WI 53701-2659; phone: 608 261-6855
Please note: This patient information is intended to provide health
professionals with information to share with their patients to help them
better understand their health and their diagnosed disorders By
providing access to this patient information, it is not the intention of
NGC to provide specific medical advice for particular patients Rather we
urge patients and their representatives to review this material and then
to consult with a licensed health professional for evaluation of
treatment options suitable for them as well as for diagnosis and answers
to their personal medical questions This patient information has been
derived and prepared from a guideline for health care professionals
included on NGC by the authors or publishers of that original guideline
The patient
information is not reviewed by NGC to establish whether or
not it accurately reflects the original guidelines content
NGC STATUS
This NGC summary was completed by ECRI on July 22, 2005
COPYRIGHT STATEMENT
This NGC summary is based on the original guideline, which is subject to
the guideline developers copyright restrictions
DISCLAIMER
NGC DISCLAIMER
The National Guideline Clearinghouse NGC does not develop, produce,
approve, or endorse the guidelines represented on this site
All guidelines summarized by NGC and hosted on our site are produced
under the auspices of medical specialty societies, relevant professional
associations, public or private organizations, other government agencies,
health care organizations or plans, and similar entities
Guidelines represented on the NGC Web site are submitted by guideline
developers, and are screened solely to determine that they meet the NGC
Inclusion Criteria which may be found at
http://wwwguidelinegov/about/inclusionaspx
NGC, AHRQ, and its contractor ECRI Institute make no warranties
concerning the content or clinical efficacy or effectiveness of the
clinical
practice guidelines and related materials represented on this
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guidelines represented on this site do not necessarily state or reflect
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Readers with questions regarding guideline content are directed to
contact the guideline developer
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1998-2008 National Guideline Clearinghouse
Date Modified: 11/3/2008
