Diagnosis and Management of Type 2 Diabetes Mellitus in Adults

[See Glycemic Control algorithm]

[See Blood Pressure Control algorithm]

[See Ongoing Management algorithm]

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Source: Institute for Clinical Systems Improvement (ICSI). Diagnosis and management of type 2 diabetes mellitus in adults. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2008 March. 88 p. Diagnosis and Management of Type 2 Diabetes Mellitus in Adults Diagnostic testing for diabetes or prediabetes. A A = Annotation Evaluation of patients with elevated glucose. A Treatment of prediabetes. A Diagnosis of prediabetes. A Diagnosis of type 2 diabetes. A Should patient be hospitalized? A Inpatient diabetes management. A Does patient need outpatient stabilization? A Initial stabilization for outpatients requiring immediate insulin treatment. A Recommend self-management program: *Nutrition therapy. *Physical activity. *Education for self-management. *Foot care. *Community resources. A Factors to consider: *Advanced age or estimated survival less than 5 years. *Advanced neurological disease (stroke, dementia). *Multiple comorbidities. *Polypharmacy concerns. Standardized treatment goals: *A1c individualized goals. *Start or intensify statin therapy. *Blood pressure control BP less than 130 / 80 mmHg. *Aspirin/antiplatelet medication unless contraindicated. *Tobacco cessation if indicated. A *History of severe hypoglycemia. *Inability to recognize hypoglycemia or to comply with standardized treatment goals. *Duration of diabetes. *Cardiovascular risk. Are treatment goals met? A Treatment goals not met: *Modify treatment based on appropriate related guideline. *See Glycemic Control and Blood Pressure Control algorithms and / or *Consider referral to diabetes health team or specialists. *Assess patient adherence. *Evaluate for depression. A See Ongoing Management algorithm All copyrights are reserved by the Institute for Clinical Systems Improvement, Inc.