Table 3

Medical history

Age and characteristics of onset of diabetes (e.g., DKA, asymptomatic laboratory finding)
Eating patterns, physical activity habits, nutritional status, and weight history
Whether or not patient wears medical alert identification
Diabetes education history; health literacy assessment
Review of previous insulin treatment regimens and response to therapy (A1C records), treatment preferences, and prior difficulty with therapies
Current treatment of diabetes, including medications and medication adherence, meal plan, physical activity patterns, and readiness for behavior change
Use of insulin, insulin pumps, carbohydrate ratios, and corrections; knowledge of sick-day rules; ketone testing; pump troubleshooting (if applicable)
Results of glucose monitoring, including SMBG and CGM and patient’s use of data
DKA frequency, severity, and cause
Hypoglycemic episodes
 Hypoglycemia unawareness
 Any severe hypoglycemia: frequency and cause
 Whether or not patient has glucagon available and someone to administer it
History of diabetes-related complications
 Microvascular: retinopathy, nephropathy, and neuropathy (sensory, including history of foot lesions; autonomic, including sexual dysfunction and gastroparesis)
 Macrovascular: coronary heart disease, cerebrovascular disease, and peripheral artery disease
 Other: dental disease
Psychosocial issues, including current or past history of depression, anxiety, eating disorders, and others; assess support systems and need for assistance
History of pregnancy and any diabetes-related complications; desire for future pregnancies
Contraception (if a woman is of childbearing age)
Smoking
Alcohol use, abuse, and impact on blood glucose levels
Illicit drug use
Driving