DM Monitoring: Labs & Comorbidities To Screen

Question 1

Which tests should be included in a lipid panel for diabetic patients? How often should it be ordered?

Answer 1

Lipid panel:
- total CHO
- LDL
- HDL
- TRI

Frequency: annually

Question 2

What age- and comorbity-related considerations should be made for diabetic patients with abnormal lipid panel results?

Answer 2

Age >/= 40 years, consider:
- mod-intensity statins
- lifestyle modifications

Any age & ASCVD risk, consider:
- high-intensity statins
- lifestyle modifications

Question 3

How often should A1C be checked for diabetes patients?

Answer 3

If at goal: twice a year
If not at goal: every 3 months

Question 4

How often should spot urine for albumin-to-creatinine ratio labs be checked for diabetic patients?

Answer 4

TIDM:
- 5 years after diagnosis
- annually thereafter

T2DM:
- at diagnosis
- annually

Question 5

How often should diabetics have serum creatinine and eGFR tested?

Answer 5

• at diagnosis
• annually
• as indicated depending on renal status

Question 6

How often should TSH be checked for diabetic patients?

Answer 6

• at diagnosis
• annually

Comments:
- TIDM
- dyslipidemia
- women >/= 50 years

Question 7

For which comorbidities should diabetic patients be screened?

Answer 7

• certain cancers:
  
  • liver
  • colon/rectal
  • pancreas
  • breast
  • endometrium
  • bladder
• hearing impairment
• sleep apnea
• fatty liver disease
• periodontal disease
• cognitive impairment
• depression
• eating disorders
• anxiety
• fractures