TY - CHAP M1 - Book, Section TI - Diabetes Mellitus A1 - Triplitt, Curtis L. A1 - Repas, Thomas A1 - Alvarez, Carlos A2 - DiPiro, Joseph T. A2 - Talbert, Robert L. A2 - Yee, Gary C. A2 - Matzke, Gary R. A2 - Wells, Barbara G. A2 - Posey, L. Michael PY - 2017 T2 - Pharmacotherapy: A Pathophysiologic Approach, 10e AB - Patient Care Process for the Management of DiabetesCollectPatient characteristics (e.g., age, race, sex, pregnant)Characteristics of diabetes (e.g., type, age of onset, initial presentation)Microvascular and macrovascular complicationsHypoglycemia episodes, symptoms, frequency, and suspected cause(s)History of diabetic ketoacidosis frequency, severity, and suspected causePatient history (past medical, family, social—dietary habits, weight history, sleep behaviors, physical activity habits)Current medications (including complementary and alternative therapies) and medication taking behaviors (e.g., adherence, injection technique)Past diabetes treatments, response to therapy, reason for discontinuationDiabetes and nutritional education (currently enrolled and completed)Self-monitorng of blood glucose (SMBG) results and self-management behaviorsSocial and cultural Issues: preferences, values, and beliefs; health literacyPhysical exam: height, weight, BMI, blood pressure, heart rate, comprehensive foot examLabs (e.g. Glucose, A1C, Scr, BUN, eGFR, fasting lipid panel, urinary albumin/Cr ratio, serum electrolytes)AssessDiagnosis and classification (See Tables 74-1 and 74-3)Microvascular and macrovascular complications and potential comorbid conditionsAchievement of A1C and glucose goals (see Table 74-6)Appropriateness, effectiveness, safety/tolerability, treatment burden, cost and adherence of current antihyperglycemic regimen and additional treatment options being consideredAchievement of weight, lifestyle or other behavioral goalsAchievement of goals for comorbidities (e.g., blood pressure, lipids, neuropathic pain)Screen for depression, anxiety, disordered eatingScreen for psychosocial problems and barriers to diabetes self-managementPlan*Set appropriate A1C and glucose goals based on age, comorbidities, and other factors (See Table 74-6)Tailored lifestyle modifications (e.g., diet, exercise, weight management)Drug therapy regimen including specific antihyperglycemic agent(s), dose, route, frequency, and duration; specify continuation and discontinuation of existing therapies (see Figure 74-4 and Tables 74-7, 74-10, and 74-11)Monitoring parameters including efficacy (e.g., A1C, SMBG), safety (medication-specific adverse effects, hypoglycemia), and timeframe (see Tables 74-5 and 74-14)Patient education (e.g., purpose of treatment, drug administration, dietary and lifestyle modification)Referrals to other providers when appropriate (e.g., diabetes educator, registered dietician, eye care professional, podiatrist, mental health professional)Implement*Provide patient education regarding all elements of treatment plan Use motivational interviewing and coaching strategies to maximize adherenceSchedule follow-up including follow-up phone calls to adjust treatmentFollow-up: Monitor and EvaluateDetermine A1C and glucose goal attainmentPresence of adverse effectsOccurrence/development/progression of diabetes-related complicationsPatient adherence to treatment plan using multiple sources of information*Collaborate with patient, caregivers, and other health professionals SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1167562976 ER -