Department of Veterans Affairs/Department of Defense (VA/DoD) Clinical Practice Guideline for the Management of Diabetes Mellitus (DM) in Primary Care. Guideline Summary

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Department of Veterans Affairs/Department of Defense (VA/DoD) Clinical Practice Guideline for the Management of Diabetes Mellitus (DM) in Primary Care. Guideline Summary

Description

This 40-page guideline summary is derived from the evidence-based clinical practice guideline, Management of Diabetes Mellitus, developed by the Department of Veterans Affairs and Department of Defense (VA/DoD). It is intended to:

  • Promote evidence-based management of individuals with diabetes
  • Identify the critical decision points in management of patients with diabetes mellitus, such as glycemic control, evaluation of the eyes and feet, and comorbid conditions (e.g., hypertension, hyperlipidemia, and renal disease)
  • Allow flexibility so that local policies or procedures—such as those regarding referrals to or consultation with diabetes teams, ophthalmology, optometry, podiatry, nephrology, and endocrinology—can be accommodated
  • Decrease the development of complications
  • Improve local management of patients with diabetes and thereby improve patient outcomes

This guideline summary addresses the following topics:

  • Recommendations with the highest evidence
  • Guideline key elements
  • Module D – Core
    • General
    • Aspirin therapy
    • Management of diabetes
    • Management core algorithm
    • Table 1: Diagnosis
    • Table 2: Evaluation
    • Table 3: Clinical classification
    • Table 4: Low density lipoprotein cholesterol thresholds
    • Table 5: High triglyceride therapy
  • Module S – Screening for diabetes
    • Screening
    • Prevention
    • Screening algorithm
  • Module G – Glycemic control
    • Assessment
    • Glycemic control target range
    • Treatment options
    • Followup
    • Glycemic control algorithm
    • Table 1: Determination of target hemoglobin A1c (HbA1c) level
    • Table 2: Sequential treatment
    • Table 3: Estimate of HbA1c
    • Table 4: Oral pharmacologic agents
    • Table 5: Comparison of insulin preparations
    • Table 6: Insulin regimen examples
    • Table 7: Guidelines for insulin adjustment
  • Module E – Eye care
    • Screening for retinopathy algorithm
  • Module F – Foot care
    • Screening and assessment
    • Treatment/referral
    • Foot care algorithm
  • Module R – Kidney function
    • Screening
    • Assessment and diagnosis
    • Treatment
    • Table 2: Factors that transiently interfere with urinary screening for albuminuria
    • Table 3: Definition of chronic kidney disease (CKD)
    • Table 4: CKD: A clinical action plan
    • Kidney function algorithm
  • Module M – Self-management and education
    • Self-management and education algorithm
    • Table 1: Recommendations

Developer:

Department of Defense; Department of Veterans Affairs; Veterans Health Administration

Funding Sources:

Department of Defense; Department of Veterans Affairs; Veterans Health Administration

History

Release Date: 2003
Original Summary: March 2005
Last Updated: 05/07/14

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