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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