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The diabetes annual cycle of care is a checklist containing information about the frequency of health checks to be undertaken to manage the risk of diabetes complications.
GP management of T2DM should be consistent with RACGP Guidelines for General Practice Management of Type 2 Diabetes. These guidelines recommend the completion of an Annual Cycle of Care for all patients with diabetes.
| Check | How Often | |
|---|---|---|
 |
Foot assessment for high risk feet | Every 1-3 months |
|
Foot assessment for moderate risk feet | Every 3-6 months |
 |
Blood pressure | At least every 6 months |
 |
Weight | At least every 6 months |
 |
Waist circumference | At least every 6 months |
 |
HbA1c | At least every 6-12 months |
|
Foot assessment for Very-low and low-risk feet | At least every year |
 |
Kidney health | At least every year |
 |
Blood fats | At least every year |
 |
Healthy eating review | At least every year |
 |
Physical activity review | At least every year |
 |
Medication review | At least every year |
 |
Smoking | At least every year |
 |
Diabetes management | At least every year |
 |
Eye examination | At least every two years |
 |
Emotional health | As needed |
Identify your at-risk patients
Identify which of your patients are overdue for elements of their diabetes cycle of care by generating a POLAR report, then establish patient recalls.
Read the POLAR Walkthrough for instructions:
POLAR Walkthrough – Type 2 diabetes patient without HbA1c record in the last 12 months
For more information about the diabetes cycle of care visit RACGP.
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