Could you provide a comprehensive visit checklist based on the previous follow‑up plan?

Visit Checklist Based on Previous Follow-Up Plan

Without seeing the specific previous follow-up plan, I cannot create a tailored checklist, but I can provide a comprehensive diabetes follow-up visit framework based on current evidence-based standards that you can adapt to your patient's documented plan.

Core Components for Every Follow-Up Visit

Interval History Assessment

• Changes in medical status since last visit
• Medication adherence and barriers: Specifically ask "Are you rationing medications or supplies due to cost?" 1, 2
• Hypoglycemia events: frequency, timing, awareness, and precipitating factors
• New symptoms suggesting complications or comorbidities
• Sleep quality and duration (associated with A1C control) 1

Physical Examination

• Height, weight, BMI (every visit) 1, 3, 2
• Blood pressure (every visit) 1, 3, 2
  • If on antihypertensive therapy: orthostatic measurements when indicated 3
• Skin examination: insulin injection sites, lipodystrophy, acanthosis nigricans 1, 3, 2
• Foot inspection if patient has sensory loss, previous ulcers, or amputations 3

Laboratory Testing (If Not Done Within Specified Timeframes)

• A1C: if not available within past 3 months 1, 3, 2
• Annual labs (if not done within past year):
  • Lipid panel (total, LDL, HDL, triglycerides) 1, 3, 2
  • Spot urinary albumin-to-creatinine ratio 1, 3, 2
  • Serum creatinine and eGFR 1, 3, 2
  • Liver function tests 1, 3, 2
  • TSH (type 1 diabetes) 1, 3, 2
  • Vitamin B12 (if on metformin) 1, 3, 2
  • Serum potassium (if on ACE inhibitors, ARBs, or diuretics) 1, 3, 2

Behavioral and Psychosocial Screening

• Depression, anxiety, diabetes distress screening 2
• Disordered eating assessment 1, 3, 2
• Social determinants of health: food security, housing stability, transportation access, financial security 3, 2

Technology and Self-Management Review

• Download and review CGM/meter data 1, 3, 2
• Review insulin pump settings if applicable 3, 2
• Assess medication-taking behavior including rationing 2

Immunization Status

• Annual influenza vaccine (if not received this season) 1, 4, 3
• Pneumococcal vaccine status per age-appropriate guidelines 4
• COVID-19 vaccination status 1

Follow-Up Planning

• Schedule next visit: every 3-6 months for most patients 1
• Referrals needed: ophthalmology (annual dilated exam), podiatry, endocrinology, behavioral health 1, 4
• Adjust treatment plan based on A1C and metabolic targets 4

Critical Pitfalls to Avoid

Do not delay the visit if A1C is not at goal—these patients need more frequent monitoring (every 3 months minimum) 1. Do not skip psychosocial screening—depression and diabetes distress directly impact glycemic control and should be assessed at every visit 1, 2. Do not forget to ask about medication rationing—this is now a standard assessment item that directly impacts outcomes 2.

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To create your patient-specific checklist: Review the documented follow-up plan from the previous visit and cross-reference it with the components above, ensuring all previously identified action items are addressed and appropriate interval assessments are completed based on the timeframes specified in the guidelines 1, 3, 2.