Screening for and monitoring of chronic complications of type 1 diabetes

glycaemic profile

physical signs

eyes

kidney disease

neuropathy

autoimmune disease

lipid levels

blood pressure

psychosocial

other aspects

SMBG results and symptoms of hyperglycaemia

HbA1c

episodes of hypoglycaemia

hypoglycaemia unawareness

assess every 3 to 4 months; see Glycaemic targets for adults with type 1 diabetes

management goals

dietary intake

physical activity and exercise

self-management education

medications

sick-day management plan

informally assess every 3 to 4 months, as part of monitoring the glycaemic profile

formally assess at least every 12 months

weight, with or without waist circumference

injection sites (for lipohypertrophy) and fingers (for damage from blood glucose checking)

assess every 3 to 4 months

retinopathy

start screening 2 to 5 years after diagnosis (after age 11 years), unless at higher risk due to comorbidities; see Diabetic retinopathy

assess at least every 12 months for:

• Aboriginal and Torres Strait Islander peoples
• any patients with previously identified retinopathy (follow-up by ophthalmologist preferred)
• any patient with a long duration of diabetes or high HbA1c (follow-up by ophthalmologist preferred).

assess at least every 2 years in all other patients if previous eye examination was normal

kidney function measurement (see Diabetic kidney disease)

start screening 2 to 5 years after diagnosis (after age 11 years) unless at higher risk due to comorbidities

assess at least every 12 months and more frequently if results are changing

foot examination [NB2]

peripheral neuropathy [NB3]

start screening 2 to 5 years after diagnosis (after age 11 years)

assess every 3 to 4 months for patients at intermediate or high risk of developing complications, especially if foot abnormality is identified

assess at least every 12 months for patients at low risk of developing complications

autoimmune screens for thyroid dysfunction and coeliac disease

for thyroid dysfunction, screen at diagnosis and then screen at least every 2 years or more frequently if the patient is symptomatic

for coeliac disease, screen at diagnosis and then screen at 2 years and 5 years after diagnosis

assess more frequently if clinical condition suggests coeliac disease or if the patient has a first-degree relative with coeliac disease

lipid level measurement [NB4]

start screening when diabetes has stabilised after diagnosis (after age 11 years) and measure every 5 years if results are normal

start screening earlier if there is a family history of hypercholesterolaemia, early cardiovascular disease or if family history is unknown

assess more frequently if not at target

blood pressure measurement [NB5]

assess at least every 12 months, and more frequently if not at target

diabetes distress

evidence of depression, anxiety or an eating disorder

for diabetes distress, assess every 3 to 4 months

for depression, anxiety or eating disorders, screen at least every 12 months

tobacco smoking

contraception and prepregnancy planning (see Overview of pregnancy in women with pre-existing diabetes)

immunisations

dental care

assess at least every 12 months, and more frequently if circumstances change