Diagnosis
–History and physical.
–Screening recommendations reviewed.
–ADA’s diagnostic criteria reviewed.
-Confirm the diagnosis of pre-DM or DM type 2 by repeating the same test on a different day (per USPSTF). Repeat in 1-2 weeks.
-Before starting Metformin, I will obtain the patient’s eGFR (per FDA).
-Will check eGFR at least annually in all patients taking metformin. In patients at increased risk for the development of renal impairment such as the elderly, renal function should be assessed more frequently.
Further Reading
Am Fam Physician 2010;81(7):863-870. Diabetes mellitus: Diagnosis and screening.
Diabetes Care 2017;40(Suppl 1): S11-S24. American Diabetes Association: Standards of medical care in diabetes—2017.