Jason C. McCarthy, MD Travis Air Force Base, Family Medicine Residency, California Jason.McCarthy.6@us.af.mil
Ryan D. Pearson, MD Travis Air Force Base, Family Medicine Residency, California
The authors reported no potential conflicts of interest relevant to this article.
The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the U.S. Air Force or Department of Defense.
Unless there are contraindications, all patients with diabetes should receive the pneumococcal and annual influenza vaccines.
CASE JR’s history shows that he is current on his influenza and pneumococcal vaccines. However, he doesn’t recall whether he’s been vaccinated against HBV. Serum testing reveals no previous immunization, and recommending HBV vaccine is appropriate.
Surveillance
The 2012 ADA recommendations do not include any new surveillance practices for microvascular disease. Providers should continue to offer the following screening to T2DM patients annually: urine albumin excretion testing and serum creatinine to assess for nephropathy, a comprehensive dilated eye exam to assess for retinopathy, and a foot exam to assess for distal symmetric polyneuropathy.4
CASE Each of these tests were performed (or ordered) for JR. We’ll see him again in 2 to 3 months for diabetes follow-up.
Acknowledgement
The authors thank Pamela Williams, MD, and Brent Smith, MD, for their guidance in the preparation of this article.
CORRESPONDENCE Jason C. McCarthy, MD, 101 Bodin Circle, Travis Air Force Base, CA 94535; Jason.McCarthy.6@us.af.mil
