This algorithm is derived from the evidence-based clinical practice guideline, Management of Diabetes Mellitus, developed by the Department of Veterans Affairs and Department of Defense (VA/DoD). It is intended to:

• Promote evidence-based management of individuals with diabetes
• Identify the critical decision points in management of patients with diabetes mellitus, such as glycemic control, evaluation of the eyes and feet, and co-morbid conditions (e.g. hypertension, hyperlipidemia, and renal disease)
• Allow flexibility so that local policies or procedures, such as those regarding referrals to or consultation with diabetes teams, ophthalmology, optometry, podiatry, nephrology, and endocrinology can be accommodated
• Decrease the development of complications
• Improve local management of patients with diabetes and thereby improve patient outcomes

This algorithm on diabetes mellitus addresses the following topics:

• Kidney evaluation
• Screening for microalbuminuria
• Referral of suspected cases of diabetic nephropathy to nephrology
• Assessing and initiating glycemic control
• Starting/adjusting treatment of angiotensin-converting enzyme inhibitor
• Monitoring random urine protein creatine ratio
• Counseling patient on reduced practice diet
• Managing blood pressure