Follow up and Monitoring

Emphasis should be placed on the importance of regular follow up. They should also acquire the knowledge and skills that enable them to modify treatment according to the results of self monitoring. The frequency of the follow up visits ranges from 3 month to 12 months.

During follow up visits:

  • Education should be reinforced,
  • Growth monitored
  • Blood Glucose Monitoring results reviewed

Glyceamic Control Monitoring:

The level of glyceamic control should always be monitored. The absence of symptoms alone should not be taken as an indicator of good control. Diabetic patients should be taught self monitoring techniques and its documentation.

Methods include:

  • Fasting and 2hours post-prandial glucose each follow up visit if feasible
  • Quarterly HbA1C
  • Yearly chemistry panel, fasting lipid profile, urinalysis (including microscopy and urine micro albumin screening)
  • ECG in adults as baseline and then as clinically indicated

Annual Review

During an annual review, surveillance of the following

  • Symptoms of Ischaemic Heart Disease, Peripheral Vascular Disease, Neuropathy and Impotence
  • Feet including Footwear, deformity or poor skin condition, ischaemia, ulceration, absent pulses, sensory impairment
  • Visual Acuity
  • Retinopathy by Opthalmoscope or retinal photography if available
  • Kidney Damage by albumin excretion and Serum Creatinine
  • Hypertension
  • Dyslipidaemia
  • Injection Sites

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