Subject: Diabetes Screening and Treatment
Effective Date: 10/13/05
Page 1 of 3
Revised:
Policy
Columbus County Health Department provides diabetes screening and treatment
services based upon local need.
 These include:
o Community outreach
o Patient self management instructions
o Screening for persons at risk
o Professional education
o Monitoring services, in cooperation with local physicians, to
provide co-management of patients diagnosed with diabetes.
Purpose
To control and reduce the burden of diabetes in Columbus County
Procedure
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This clinic provides diabetes education, screening, counseling and
monitoring services
Recruitment/Outreach
o Diabetes services are promoted through:
 Media
 Other health department clinics
 Community Health Fairs
 Civic Programs
 Referral from Private Physicians
 Hospital referrals
The Problem Oriented Health Record is used for service documentation
 Personal Data (DEHNR-2800)
 Problem Need List (DEHNR-2801)
 Adult Basic History
 Adult Physical Exam/System Review (DEHNR-2806)
 Notes (DEHNR 2803)
 Medication Flow Sheet (DEHNR-2802)
 Immunization/Skin Test Flow Sheet (DEHNR-2817)
 Referral/Follow-up Form (DEHNR-2734)
 Dietary Recall/Food Frequency Flow Sheet (DEHNR2813)
Other Forms include:
 Laboratory reports
 Correspondence on letter head
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Subject: Diabetes Screening and Treatment
Page 2 of 3
Effective Date: 10/13/05
Revised:
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Consent Forms
Release of information forms
Community Based Risk Factor Assessment (DEHNR3773)
Columbus County Health Department Blood Cholesterol
Screening Form
Request for monitoring orders
Diabetes Care Plan
Knowledge and Skills Assessment
Page are placed in accordance with the Record Policy Manual (See
attached sample chart)
Medical Services
o Screening services are aimed at identifying the person who is
either at risk of developing diabetes or who already has the disease
and needs monitoring and education in order to minimize
complications.
 Screening services are provided as a component of the
annual screening physical and as a component of Health
Fairs
 Monitoring Services are provided to patients who need
assistance managing their diabetes. (See protocols for
diabetes screening, referral and monitoring)
 Patients screened and referred to Private Medical Physician
due to abnormal high blood sugar results may not continue
screening procedure. (See protocol)
 Monitoring services are based on the Diabetes Control
Program tailored to meet local needs (See protocol for
Adults with Diabetes)
Clinical Protocols:
Clinical protocols are based on guidelines from:
 Clinician’s Handbook of Preventive Services

The Preventive and Treatment of Complications of Diabetes: A Guide for
Primary Care Practitioners, 1991, Department of Health and Human
Services.

American Diabetes Association Clinical Practice Recommendation,
current year edition.
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Subject: Diabetes Screening and Treatment
Page 3 of 3
Effective Date: 10/13/05
Revised:

Medical Management of Non-Insulin Dependent (Type II)Diabetes, Thrid
Edition, American Diabetes Association Inc, 1994

Hypertension Management in Diabetes, National Institutes of Health, 1995
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For further information, reference the Role of the Regional Health
Promotion Nurse Consultant, Nutrition Consultant and Community Health
Education Consultant.