| Vascular disease |
Regular checks of risk factors such as A1C, blood pressure, serum lipids, and urine albumin excretion and regular foot examination for early detection of peripheral vascular disease |
| Physical and neuropathic complications |
FRAIL Scale: presence of ≥3 of the following is diagnostic of frailty: |
| 1. Fatigued (self-reported) |
| 2. Resistance (unable to climb a flight of stairs) |
| 3. Ambulation (unable to walk a block) |
| 4. Illness (>5 comorbidities) |
| 5. Lost weight (>5 kg in the previous 6 months) |
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SARC-F Scale*: total score ≥4 for the following is predictive of sarcopenia and adverse outcomes: |
| 1. Strength (difficulty lifting a 10-lb weight) |
| 2. Assistance in walking (difficulty walking across a room) |
| 3. Rise from a chair (difficulty in transferring from chair to bed) |
| 4. Climbing stairs (difficulty in climbing a flight of stairs) |
| 5. Falls (number of falls in the past year) |
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| *Answer options: For items 1–4, 0 = none, 1 = some difficulty, 2 = unable; for item 5, 0 = no falls, 1 = 1–3 falls, 2 = ≥4 falls |
| Mental dysfunction |
Mini-Cog*: a score ≤3 of the 5 items below defines cognitive impairment: |
| • Ask the patient to draw the numbers of the clock face (task). |
| • Ask the patient to draw the hands of the clock to show the time as 10 minutes to 3:00 (task). |
| • Ask the patient to recall the three items (recall memory items). |
| *Provide a clock face for the first two items. Ask the patient to recall three things such as lemon, key, and balloon for the final item. Score 1 for each task performed and for each item recalled. |
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Two-Item Patient Health Questionnaire (PHQ-2)* |
| • Ask whether patient has little interest in doing things. |
| • Ask whether patient is feeling down, depressed, or hopeless. |
| *Any positive answer triggers assessment using the nine-item PHQ-9. |
