q     Assess depression annually or as clinically indicated using the PHQ-2 or PHQ-9

q     Provide timely diagnostic and therapeutic services for anyone with a positive screen

q     Refer patients and their families for DSME at diagnosis and as needed thereafter

q     Refer to diabetes educator to complete an education needs assessment and establish self-management education and care plan

q     Refer patient to registered dietitian for individualized MNT at diagnosis and as need thereafter to achieve treatment goals

q     Screen and re-assess macrovascular and microvascular complications that may be worsened with physical activity

q     Provide and modify exercise prescription based on the medical evaluation

q     Provide education on proper footwear

q     Evaluate for risk for hypoglycemia and make appropriate adjustments in pharmaceutical and non-pharmaceutical therapies as needed

q     Screen for tobacco use at diagnosis and periodically thereafter

q     Advise all patients not to smoke or use tobacco products 

q     Refer to tobacco cessation program as indicated. Nicotine replacement therapy recommended

q     Screen for alcohol and substance use at diagnosis and periodically thereafter

q     Counsel on appropriate use of alcohol.  Moderation is considered one daily drink for adult women and two drinks for adult men

q     Refer patients with alcohol or substance abuse to appropriate behavioral health staff or treatment program

q     Advise abstention from alcohol for women during pregnancy and for people with medical problems such as pancreatitis, advanced neuropathy, severe hypertriglyceridemia, or alcohol abuse