Principles of patient coordination

The American Diabetes Association (ADA) “Standards of Care in Diabetes”

includes the ADA’s current clinical practice recommendations and is intended to
provide the components of diabetes care, general treatment goals and guidelines,
and tools to evaluate quality of care. The top 10 things that must be done for a
diabetic patient over time according to the ADA include:

1. Regular Glucose Monitoring: Monitoring blood sugar levels helps in making

necessary adjustments and understanding the effectiveness of treatments. A
HgA1c goal for many adult males, and nonpregnant females of <7% and pregnant
females of <6% without significant hypoglycemia is appropriate.

2. Blood Pressure Control: Monitor and manage blood pressure levels to reduce the
risk of cardiovascular complications.

3. Lipid Management: Assess lipid profile and prescribe statins or other lipid-
lowering medications to manage dyslipidemia and reduce cardiovascular risks.

4. Kidney Function Monitoring: Regularly assess kidney function through urine

albumin-to-creatinine ratio and estimated glomerular filtration rate (eGFR) to
detect and manage diabetic kidney disease.

5. Eye Examinations: Refer patients for regular eye examinations to detect and
manage diabetic retinopathy.

6. Foot Care: Educate patients about proper foot care and refer them for regular foot
examinations to prevent and manage diabetic foot complications.

7. Lifestyle Modifications: Encourage and support the adoption of a healthy

lifestyle, including a balanced diet, regular physical activity, and weight
management.

8. Individualized Treatment Plan: Develop an individualized treatment plan based

on the patient's type of diabetes, age, comorbidities, and personal preferences.
9. Medication Management: Prescribe appropriate medications, including insulin or
oral hypoglycemic agents, to achieve and maintain targeted blood glucose levels.
10. Diabetes Self-Management Education and Support: Provide diabetes self-
management education and support to empower patients in managing their
condition effectively.