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<div class="content">
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<h1>Toolkit for Implementing the Chronic Care Model in an Academic Environment</h1>
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<h2>Glycemic Control Algorithm 1</h2>
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<div class="contextual-region block block-ahrq-pubhierarchy block-ahrq-pubhierarchy-toc">
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<h3>Table of Contents</h3>
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<ul>
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<li><a href="/prevention/curriculum/chroniccaremodel/index.html">Toolkit for Implementing the Chronic Care Model in an Academic Environment</a></li>
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<li><a href="/prevention/curriculum/chroniccaremodel/chronicack.html">Acknowledgments</a></li>
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<li><a href="/prevention/curriculum/chroniccaremodel/chroniccare1.html">1. Engaging Leadership</a></li>
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<li><a href="/prevention/curriculum/chroniccaremodel/chroniccare2.html">2. Harnessing the Academic Culture</a></li> <li><a href="/prevention/curriculum/chroniccaremodel/chroniccare3.html">3. Implementing the Chronic Care Model into Practice</a></li><li>
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<a href="/prevention/curriculum/chroniccaremodel/chroniccare4.html">4. Health Professions Education for Chronic Care</a></li> <li> <a href="/prevention/curriculum/chroniccaremodel/chronicgloss.html">Glossary</a></li> </ul>
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<article role="article" class="contextual-region node node--type-ahrq-publication node--view-mode-full clearfix" about="/prevention/curriculum/chroniccaremodel/chronic2a7.html">
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<div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>The Planned Visit Notebook includes a step-by-step description for a diabetes planned visit. The Glycemic Control Algorithm is a flowchart that takes a health professional through the steps for one part of the diabetes planned visit.</p>
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<p><span><img alt="Glycemic Control Algorithm for DM1: Goal A1c greater than 7.0. For details, see Text Description below." border="0" height="449" src="/prevention/curriculum/chroniccaremodel/chronic2a7fig.gif" title="Glycemic Control Algorithm for DM1: Goal A1c greater than 7.0. For details, see Text Description below." width="721" /></span></p>
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<h3>Text Description</h3>
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<div>The Glycemic Control Algorithm for DM1 begins with a text box that reads:
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<table border="1" cellpadding="8" cellspacing="0" summary="layout" width="40%"><tbody><tr><td align="center">Algor Assess A1c result<br />
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Note: A1c result should be no older than 3 months</td>
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</tr></tbody></table>
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Two arrows lead from it. The one to the left is labeled "A1c <7.0" and points to a box that reads:
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<table border="1" cellpadding="8" cellspacing="0" summary="layout" width="20%"><tbody><tr><td align="center">Recheck in 3 months</td>
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</tr></tbody></table>
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The one to the right is labeled "A1c <u>></u>7.0" and points to a box that reads:
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<table border="1" cellpadding="8" cellspacing="0" summary="layout" width="80%"><tbody><tr><td><strong>Planned Visit</strong>—complete assessment of glycemic control program (see <strong>Module 4 Podcast</strong>)<br />
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—Advise relevant lifestyle changes</td>
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</tr></tbody></table>
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Two arrows lead from this box to two boxes below it. The box to the left reads:
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<table border="1" cellpadding="8" cellspacing="0" summary="layout" width="80%"><tbody><tr><td>
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<p><strong>Group 1: Control goal attainable by dosage changes within current regime (generally A1c 8.0 or less)</strong></p>
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<p>NP with endocrinologist/staff oversight adjust doses makes HGM recommendations</p>
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<p>Contact patient in 1 week (visit or otherwise to assess effectiveness of changes), then no less often than monthly. Change as necessary with staff oversight.</p>
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<p>Recheck A1c in 3 months</p>
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</td>
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</tr></tbody></table>
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The box to the right reads:
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<table border="1" cellpadding="8" cellspacing="0" summary="layout" width="80%"><tbody><tr><td>
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<p><strong>Group 2: Control goal is not attainable by dosage changes within current regime (generally A1c >8.0)</strong></p>
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<p>Contact endocrinologist for change in regimen or arrange a team meeting. Initiate a regime as soon as possible, including that day.</p>
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<p>Contact patient in 1 week (visit or otherwise to assess effectiveness of changes) and make further recommendations with staff oversight.</p>
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<p>Recheck A1c in 3 months</p>
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</td>
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</tr></tbody></table><p>A note at the bottom of the algorithm reads:</p>
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<p><strong>Note:</strong> Team Meetings option at any point for scope of changes necessary, lack of progress not limited to adherence issues, or nurse practitioner wishes. Team meeting optional at any point for lack progress—as determined by nurse practitioner.</p>
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<p><a href="/prevention/curriculum/chroniccaremodel/chronic2a.html">Return to Document</a></p>
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<section class="row region region-citation">
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<div data-contextual-id="context_block:context=citation&reaction_id=blocks&block_id=68cfb074-24da-4680-9a96-cdb022b3ebb0:langcode=en" data-contextual-token="zvnTeYSozxOcifNxfZ9rrF8zpPZMKL_bnanTbknklYY"></div>
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<div class="content">
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<div id="created-reviewed-citation" class="pad-bottom-sections">
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<div id="page-reviewed" class="body-copy-italic">Page last reviewed October 2014</div>
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<div id="page-created" class="body-copy-italic">Page originally created January 2008</div>
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<div class="twocolordiv-content">
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<p>
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<span class="citation-hdr">Internet Citation:</span> Glycemic Control Algorithm 1. Content last reviewed October 2014. Agency for Healthcare Research and Quality, Rockville, MD.<br>
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<span class="citation-url">https://archive.ahrq.gov/prevention/curriculum/chroniccaremodel/chronic2a7.html</span>
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</p></div>
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