MEDizzy - A 55-year-old type-2 diabetic patient has lost weight and

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Metabolic diseases

A 55-year-old type-2 diabetic patient has lost weight and has had good control of his blood glucose on oral metformin, with HgA1c of 6.4%. He has a history of mild hypertension and hyperlipidemia. Which of the following statements is correct regarding routine testing for diabetic patients?

ExplanationGuidelines for ongoing medical care in diabetic patients recommend that the following screenings or interventions be performed annually: dilated eye examination, lipid profile, and medical nutrition therapy and education. Annual screening for diabetic nephropathy begins with a dipstick assessment of urine protein and, if negative, testing of a single voided specimen for albumin/creatinine ratio. Twenty-four-hour urine testing is not recommended. A foot examination should be performed yearly by the physician and daily by the patient. Peripheral neuropathy is first suggested by distal loss of sensation on clinical exam. HgA1c testing should be performed 2 to 4 times a year depending on the patient’s diabetes control (if the patient's HgA1c at goal, twice yearly is adequate). Blood pressure should be measured quarterly. Home glucose measurements are usually performed once daily in well-controlled type 2 diabetics.