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1. Diabetes Planned Visit Algorithm 2. Decision Support 2.11 Decision Support BP 2.12 Decision Support BP titration orders 2.13 BP Protocol Flow Sheet 2.14 BP Medications 2.20 Decision Support Glucose 2.30 Decision Support Microalbumin 3. Self Management Goal Sheets 4. Pre-Visit Questionnaire 5. Outpatient Dietitian Referral Form—(Not included) 6. Summa Diabetes Center Referral Form—(Not included) 7. MNT Referral—(Not included) 8. Tobacco Quit Line Referral—(Not included) 9. Smoking Cessation Community Resources Stickey 10. Tobacco Use Cessation Stickey—(Not included) 11. Bupropion SR Stickey—(Not included) 12. Therapeutic Shoes Request 13. Lab Stickey—(Not included) 14. Glucagon/OTC Stickey—(Not included) 15. Insulin syringe Stickey—(Not included) 16. Pen and Pen needle Stickey—(Not included) 17. Insulin Vials Stickey—(Not included) 18. Meters and Test Strips Stickey—(Not included) 19. Lancet's Stickey—(Not included) 20. Monofilament—(Not included) 21. ACIC Forms—(Not included) 22. Blood Sugar Diary 23. Type 2 Diabetes 24. Hypoglycemia 25. Exercise 25.11 Safe & Healthy Exercise 25.12 Exercise for Diabetics 26. Oral Diabetes Medications 27. Blood Glucose and Urine Ketone Testing 28. All About Insulin 29. Diabetes 29.11 Preparing for Sick Days 29.12 Sick Day Record 30. Alcohol and Diabetes 31. Steps to Healthy Feet 32. Eye Care and Retinopathy 33. Recognizing Stroke & TIA Symptoms 34. High Blood Pressure 35. Heart Disease Booklet—(Not included) 36. Other 36.1 Selected Preventive Foot Care Guidelines and Resources for Providers & Patients with DM 36.2 Your Insulin Regimen Day of Surgery 36.3 Your Insulin Regimen 36.4 Your Insulin Day of Surgery Mixed 36.5 Smoking—Is This the Right Time to Quit? 36.6 Handout—Nicotine Gum 36.7 Handout—Nicotine Lozenge 36.8 Handout—Nicotine Patch 36.9 Handout—Nicotrol Inhaler 36.91 Handout—Nicotrol NS 36.92 Handout—NRT & Bupropion combined 36.93 Physician checklist/instructions for starting Insulin 36.94 Physician Pharmacologic guidelines
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