pp slides diabetes microvascular complications€¦ · diabetes in phpc settings 8 8.2 8.4 8.6 8.8...
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![Page 1: PP Slides Diabetes Microvascular Complications€¦ · Diabetes in PHPC Settings 8 8.2 8.4 8.6 8.8 9 9.2 2012 2013 2015 2016 8.42 8.66 8.72 8.83 8.64 8.67 9.1 9.2 Percentage of Patients](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e35237e708231d43e20b8/html5/thumbnails/1.jpg)
Diabetes: Microvascular Complications
National Center for Health in Public Housing
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Diabetes in PHPC Settings
8
8.2
8.4
8.6
8.8
9
9.2
2012 2013 2015 2016
8.428.66 8.72
8.838.64 8.67
9.19.2
Percentage of Patients with Diabetes served by PHPCs
All Health Center Programs Public Housing Pr imary Care
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HBA1c>9 in PHPC Settings
32%
68%
Percentage of Patiens with Uncontrolled Diabetes in PHPC Settings
HbA1c>9 HbA1c<9
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Barriers to Successful Management of Diabetes• Clinical limitations
• Clinical inertia
• Underutilization of team support
• Treatment nonadherence:
*psychosocial
*environmental
*interpersonal
*socioeconomic
*treatment-related
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Diabetes Self-Management Education and
Support
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Diabetes Programs
and Initiatives
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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
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Diabetic Retinopathy• Screening
o Adults with type 1 diabetes should have an initial dilated and comprehensive eye examination within 5 years after the onset of diabetes
o Patients with type 2 diabetes should hae an initial dilated and comprehensive eye examination at the time of diagnosis
o Subsequent dilated retinal examinations should be repeated at least annually
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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
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Diabetes & Foot Care• Recommendations
o Perform a comprehensive foot evaluation at least annually to identify riks factors for ulcers and amputations
o All patients with diabetes should have their feet inspected at every visit
o 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