| |
|
|
|
|
A1C
- At least twice each year
Usual goal: less than 7 |
|
Date:
|
|
|
|
|
|
|
Result:
|
|
|
|
|
|
BLOOD
PRESSURE (BP)
- Each visit
Usual goal: less than 130/80 |
|
Date:
|
|
|
|
|
|
|
Result:
|
|
|
|
|
|
CHOLESTEROL
(LDL)
- Once each year
Usual goal: less than 100 |
|
Date:
|
|
|
|
|
|
|
Result:
|
|
|
|
|
|
WEIGHT
- Each visit
My Goal: _______ |
|
Date:
|
|
|
|
|
|
|
Result:
|
|
|
|
|
|
| Diabetes
Care |
Date |
Result |
| Each
visit |
|
Foot
check
|
|
|
|
Weight
check
|
|
|
| Twice
each year |
| Dental
exam |
|
|
| Once
each year |
| Dilated
eye exam |
|
|
| Complete
foot exam |
|
|
|
Kidney
check
|
|
|
| Flu
shot |
|
|
| At
least once |
| Pneumonia
shot |
|
|
|
Note:
You can print out this handy page to help you to keep track of
your medical and diabetic check-ups.
|
| |
|
| |
|
State
of the Art Diabetic Care
One Patient At a Time
|
|
| |
| |
|
Click Here to E-mail This Page to a Friend
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