Dayspring Family Health Center



Explanation for Diabetes Flow Sheet

Posted to Virtual Office 5/5/03

David Bosscher, DO, FAAFP

Dayspring Family Health Center

The flow sheet has 2 parts: The first page is designed to be the front of the page and is a diabetic flow sheet. The second page is designed to be the back of page 1 (our chart pages attach at the top and, therefore, we copy the 2nd page upside down on the back) and provides standards for diabetic care.

• The flow sheet is designed to include (almost) ALL information from the PECS encounter form. Our providers found it hard to flip between the flow sheet and the PECS form. Thus, (almost) all data is abstracted from the flow sheet when entering data into PECS.

• We only utilize the flow sheet for planned checkup visits. It is not used during episodic visits.

|Date |

|Weight |

|Height (initial) |

|Blood pressure We ask about home pressures and give credit for meeting BP goal if home pressures are in control range |

|Goal: 27.8 kg/m2 in men

• Albuminuria (micro or macro)

• Lipids:

o Cholesterol >200 mg/dl

o Low-density lipoprotein cholesterol >100 mg/dl

o High-density lipoprotein cholesterol 100

Use after exercise/diet for persistent LDL>130

Use after all means if persistently LDL>100

ACE use: Use EARLY rather than late

DM Type 1, use ACE inhibitors for hypertension or microalbumin or macroalbumin

DM Type 2, use ARB (ACE’s OK, too) for hypertension or microalbumin or macroalbumin

(if one class is not tolerated, substitute the other class)

Microalbumin Easiest method: AM spot urine collection for albumin/creatinine ratio

Detection: Normal 300

Pneumovax: Recommended for all diabetics.

Re-vaccination if >65 and vaccinated >5 yr ago

Self- Goal # Goal

Management: 1 Work hard to keep HbgA1C < 7

2. Exercise for 30 min ___ days per week

3. Check feet daily

4. Follow calorie controlled, low fat diet

5. Lose ___ lb before next visit

6. Take ASA every day

7. Stop smoking

8. Get yearly eye exam

9. Home glucose monitoring as recommended

10 Share feelings about my diabetes

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