Diabetes Workup Calculator

	B	C	D	G	I	K	P	S	W	Y	AA	AD	AG	AL	AQ	AS	CK	CM
1			Diabetes Workup Calculator														3/10/2017	foot exam date
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3	Subjective																FALSE	retinopathy true/false
4			Patient														3/10/2017	eye exam date
5			Our 10:00 AM patient is John Doe, a 71 year-old white male newly referred to us by Smith, MD for diabetes management.
6																	13	a1c value
7																	4/10/2019	a1c date
8			Previous Visits
9			2019-08-20 Smith, G (MD): Has diabetes but is having trouble with adherence due to cost. Please adjust insulin and oral medications as necessary to achieve A1C goal.
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14			Past Medical History				Medication				Indication		Date	Interaction		Severity	98	alb:cr value
15			Chronic Kidney Disease				Amlodipine 10 mg QD				Blood Pressure		4/10/2018				1/14/2017	alb:cr date
16			Depression				Lisinopril 20 mg QD				Blood Pressure		4/10/2018
17			Diabetes Mellitus Type 2				Atorvastatin 20 mg QD				Cholesterol		4/10/2018				new	visit type
18			Hypertension				Sertraline 100 mg BID				Depression		2/16/2013
19			Peripheral Neuropathy				Levemir 50 units QD				Diabetes		7/15/2018				Yes	diabetes?
20			Tobacco Use Disorder				Metformin 500 mg BID				Diabtes		4/10/2018
21							Empagliflozin 10 mg QD				Diabtes		4/10/2018				71	age
22																	1/14/2013	date of last PPSV23
23														Allergy	Reaction		2/15/1953	dob
24														Peanuts	Anaphylaxis
25														Penicillin	Rash
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32	Objective
33			Vitals			Date		Labs		Date		Exams	Date
34			Height	68	in	4/10/2018	Glycemic Control	A1C	13	4/10/2019		Eye	3/10/2017
35			Weight	214	lb		Glycemic Control	eAG	330	4/10/2019		Foot	3/10/2017
36			BMI	32.6	kg/m^2		Lipids	TC	154	4/10/2019
37			IBW	68.4	kg			HDL	50			Vaccines	Date
38			ABW	79.9	kg			TG	130			Influenza	9/5/2019
39			BSA	2.16	m^2			LDL	78			PPSV23	1/14/2013
40			SBP	133				ASCVD risk	DM			PCV13	5/5/2016
41			DBP	72			Kidney Function	SCr	2.7	4/10/2019
42								eCrCl	28
43								eGFR	25
44								K	4.5
45								Urine Alb:Cr	98	1/14/2017
46							Liver Function	AST	56	4/10/2019
47								ALT	48
48								Alb	4.2
49								INR	1	3/2/1015
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52		Assessment and Plan
53		Please refer to the automatic assessments below before writing assessment and plan.
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72		Automatic Assessments
73		Adherence: Consider cost, adverse effects, regimen complexity, dislike injections, etc.
74		ASCVD risk determination is unnecessary because patient has diabetes
75		Blood Pressure Control: SBP >130: Consider adjusting hypertension medication
76		CONTRAINDICATION: Patient's eGFR is <30. Empagliflozin is contraindicated. Discontinue empagliflozin.
77		CONTRAINDICATION: Patient's eGFR is <30. Metformin is contraindicated. Discontinue metformin.
78		Exams: Eye exam is due now (without retinopathy, eye exams are due every 2 years)
79		Exams: Foot exam is due now (foot exams are due once a year)
80		Glycemic Control: A1C >7 (high)
81		Kidney Function: eCrCl <30: Do not use metformin, SGLT2 inhibitors, exenatide, or glyburide. Dose adjust if on sitagliptin or alogliptin.
82		Kidney Function: Patient has albuminuria.
83		Labs: A1C is due now (last A1C over goal and more than 3 months ago)
84		Labs: Lipid panel is due now. Last lipid panel was more than a year ago. Lipid panels are due 4 to 12 weeks after cholesterol medication initiation and dose adjustments, then at least every 12 months thereafter.
85		Labs: Urine test is due now (urine tests are due once a year)
86		Lifestyle: Patient is obese (BMI 32.6). May lose weight with metformin, GLP1, SGLT2, or pramlintide. May gain weight with TZDs, SU/GLNs, and insulin.
87		Lipid Control: Diabetes and age 40-75: Use a moderate-intensity statin. Consider a high-intensity statin if: long duration D2M (>10 years), albuminuria, eGFR <60 mL/min/1.73 m^2, retinopathy, neuropathy, ankle brachial index <0.9
88		Liver Function: AST elevation: Check all medications for hepatic adjustments. Avoid or monitor while on metformin, TZDs, alogliptin, statins, and other potentially hepatotoxic drugs.
89		PMH of CKD: Do not use if eGFR (mL/min/1.73 m^2) or eCrCl (mL/min) <30: metformin, SGLT2 inhibitors, exenatide, glyburide
90		PMH of Peripheral Neuropathy: Do not use canagliflozin
91		Vaccines: PPSV23 is needed. Patient's last PPSV23 was given before age 65. Patient is now older than 65 and it has been at least 5 years since their last dose.
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