Topics
- Assess Safety
- Assess Diabetes Targets
1. Assess Safety
- We advise you to include a safety assessment in your appointment "agenda". See Agenda Setting for more details.
- These key safety concerns may impact patient targets and priorties:
- Psychosocial
- Hypoglycemia
- Hyperglycemia (DKA, HHS)
- Pregnancy
- Signs of Vascular Event
- Foot Wound
- Visit our Safety Checklist page for questions to ask, what to do in case of urgent concern and resources.
2. Assess Diabetes Targets
Diabetes targets have been simplified by Diabetes Canada into the ABCDES3 as shown in table below. The table below can also be accessed in the Diabetes Canada 2018 Quick Reference Guide.
B - Blood Pressure
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Target < 130/80 mmHg
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C - Cholesterol
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LDL < 2.0 or > 50% reduction from baseline
Alternate targets include: apo B < 0.8 g/L and non-HDL-C < 2.6 mmol/L
Some physicians are not using LDL targets alone. They are assigning medications based on risk factors present, as does the Diabetes Canada Reducing Vascular Risk Tool.
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E - Exercise and Healthy Eating
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Aerobic exercise: At least 150 minutes of moderate to vigorous activity/week Resistance exercise: 2-3x/week
Healthy Eating assessment: See our webpage on Nutrition (currently in development). Consider referral to a Registered Dietitian (Diabetes Services Calgary).
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S - Screening for Complications
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ECG every 3-5 years if ˃40 or diabetes complications.
Retinal exam every 1-2 years or as advised by eye specialist.
Urine Albumin/Creatinine ratio and eGR annually. ACR target < 3.0, eGFR > 60. (Ckdpathway.ca tool)
Foot exam at least once a year (see our Foot Care page).
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S - Smoking Cessation
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Assess if currently smoking and ask permission to advise on cessation. Smoking cessation resources on our Topics Catalogue.
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S - Self Management, Stress, and other barriers
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Using appropriate client centered counseling is key when assessing all diabetes targets. Click on Client Centered Counseling for information on "Assessing Conviction/Confidence" and "Goal Setting".
Stress management resources can be found on our Topics Catalogue.
We encourage you to create your own question to help assess stress level and other psychosocial barriers. See Safety Checklist - Psychosocial - for the example: "What, if anything, is getting in the way of you taking care of your health?"
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