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Diabetes Mellitus Algorithm R: Kidney Function


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
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Department of Defense; Department of Veterans Affairs; Veterans Health Administration

Funding Sources

Department of Defense; Department of Veterans Affairs; Veterans Health Administration

QualityTool Topic


Links to National Guideline Clearinghouse or National Quality Measures Clearinghouse:

This tool is derived from the following guideline in the National Guideline Clearinghouse (NGC): VA/DoD clinical practice guideline for the management of diabetes mellitus:


  • Release Date: 03/2003
  • Original Summary: 03/2005
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Last updated: November 14, 2012.