Diabetes: Microvascular Complications and Foot Care

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Presentation transcript:

Diabetes: Microvascular Complications and Foot Care National Center for Health in Public Housing Clinical Quality Working Group

Diabetes in PHPC Settings

HBA1c>9 in PHPC Settings PHPC: obese/overweight: 15% PHPC: Hypertension: 29.9%

Barriers to Successful Management of Diabetes Clinical limitations Clinical inertia Underutilization of team support Treatment nonadherence: *psychosocial *environmental *interpersonal *socioeconomic *treatment-related

Diabetes Self-Management Education and Support

Diabetes Programs and Initiatives

Diabetic Kidney Disease Screening At least once a year assess urinary albumin and eCGR in patients with type 1 diabetes with duration of >5years, in all patients with type 2 diabetes, and in all patients with comorbid hypertension

Diabetic Retinopathy Screening Adults with type 1 diabetes should have an initial dilated and comprehensive eye examination within 5 years after the onset of diabetes Patients with type 2 diabetes should hae an initial dilated and comprehensive eye examination at the time of diagnosis Subsequent dilated retinal examinations should be repeated at least annually

Diabetic Neuropathy Screening All patients should be assessed for diabetic peripheral neuropathy starting at diagnosis of type 2 diabetes and 5 years after diagnosis of type 1 diabetes and at least annually thereafter

Diabetes & Foot Care Recommendations Perform a comprehensive foot evaluation at least annually to identify riks factors for ulcers and amputations All patients with diabetes should have their feet inspected at every visit Patients with symptoms of claudication or decreased or absent pedal pulses should be referred for ankle-brachial index and for further vascular assessment as appropriate