The treating physician, with the assistance of other health care providers, should review the initial diabetic treatment plan with the inmate. Involvement of the diabetic inmate in the development of the treatment plan is pivotal to its success, including adequate training to empower the patient to prevent and treat hypoglycemia. The treatment plan should include the following basic components and recommendations:
• Education on diabetes drug treatment options, self-monitoring, recognizing and treating severe hypoglycemic and hyperglycemic episodes, and identifying the signs of diabetic complications such as diseases of the eyes, kidneys, and nervous system.
• Instruction on the inmate’s specific drug treatment regimen and methods for monitoring glucose.
• Necessary lifestyle modifications such as improving food selection, increasing physical exercise, and smoking cessation.
• Importance of annual eye exams (funduscopic) done by an optometrist or ophthalmologist.
• Need for daily self-examination of the feet.
• Need for daily self-examination of the skin, including insulin injection sites.
• Importance of regular dental examinations and treatment.
• Need for regular screenings: fasting blood glucose, A1C, lipid levels, and kidney monitoring (BUN, creatinine, glomerular filtration rate calculation).
• Need for daily aspirin therapy to prevent cardiovascular events.
• Need for annual influenza vaccinations and tuberculosis screening.
Dec 192010