Additional Health Topics to Address for This Patient
Several important health topics should be addressed for this patient beyond the immediate presenting concern, including preventive care, mental health screening, and social determinants of health.
Comprehensive Health Assessment
- A complete medical evaluation should include assessment of diabetes and other chronic conditions, with attention to complications and comorbidities 1
- Review personal history of complications and common comorbidities, including obesity, obstructive sleep apnea, and non-alcoholic fatty liver disease 1
- Assess vaccination history and needs, ensuring all recommended immunizations are up-to-date 1
Preventive Care and Screening
- Discuss age-appropriate cancer screenings, including those recommended by the American Cancer Society based on the patient's age, gender, and risk factors 2
- Evaluate cardiovascular risk factors and consider appropriate assessments as recommended by the American College of Cardiology 2
- Review bone health and consider bone density testing if the patient has risk factors for osteoporosis 2
Mental Health Assessment
- Screen for depression, anxiety, and diabetes distress, which can significantly impact disease management and quality of life 1
- Assess for fear of hypoglycemia and disordered eating, which are particularly important in patients with diabetes 1
- Consider using open-ended questions about the impact of physical symptoms on daily life to identify patients who may need additional psychological support 1
Social Determinants of Health
- Assess food insecurity, which affects up to 20% of individuals with diabetes and is associated with lower engagement in self-care behaviors and worse glycemic management 1
- Evaluate housing insecurity/homelessness and financial barriers to inform treatment decisions 1
- Consider social capital/social community support and refer to appropriate local community resources as needed 1
Sexual Health
- For adolescent patients, address physical, psychological, and safety needs related to sexual health 1
- Assess for safety concerns related to potential perpetrators, including whether the patient has been threatened or is afraid of anyone 1
Lifestyle Factors
- Promote healthy behaviors including nutrition, exercise, safe sex, and effective contraceptive use 1
- Recommend aerobic physical activity of at least 150-300 minutes per week of moderate intensity or 75-150 minutes per week of vigorous intensity 1
- Discourage risky behaviors such as smoking, excessive alcohol consumption, and substance abuse 1
Preconception Care (if applicable)
- For women of reproductive age, discuss preconception health, including folic acid supplementation and management of chronic conditions before pregnancy 1
- Review current medication use for potential teratogenic effects and consider alternatives if pregnancy is planned 1
Medication Review and Adherence
- Review all current medications, including prescription drugs, over-the-counter medications, supplements, and herbal remedies 2
- Assess medication-taking behavior, including potential rationing of medications due to cost or other factors 1
- Evaluate for medication intolerance or side effects that may affect adherence 1
Follow-up Planning
- Discuss when to schedule the next appointment and any needed specialist referrals 2
- Consider involving community health workers to support management of diabetes and cardiovascular risk factors, especially in underserved communities 1
By addressing these additional health topics, providers can deliver more comprehensive care that addresses the patient's overall health needs beyond their immediate concerns.