diabetes

Diabetes

Overview

Use this skill for diabetes as a condition-specific grounding and tracking layer. Maintain detailed diabetes information in diabetes.md, while keeping health.md updated with diabetes status, skill attachment, linked file entry, and open follow-up questions.

Medical Grounding (Load First)

• This skill and its reference files are not reviewed by a medical professional.
• Before answering diabetes-specific health questions, read references/​diabetes-clinical-grounding.md.
• Use it to ground responses in core diabetes priorities, red flags, and high-value follow-up questions.
• Treat it as a high-level clinical orientation for the agent, not a clinical protocol or individualized treatment plan.
• If the user asks for region-specific recommendations, clarify country/​region and defer to local guidelines where they differ.

Core Workflow

Follow these steps in order unless the user requests a narrower action.

1. Confirm Scope and Safety

• Identify whether the user is:
  • describing diagnosed diabetes
  • describing possible diabetes / abnormal glucose findings
  • asking a general diabetes question without personal diagnosis
• If diagnosis/​status is uncertain, coordinate with health skill behavior:
  • use Unconfirmed Findings in health.md for inferred/​uncertain diabetes
  • ask targeted follow-up questions before treating it as a confirmed diagnosis
• If severe symptoms or possible urgent complications are mentioned, prioritize urgent care / emergency guidance instead of routine tracking.

2. Update health.md (Master Record)

• Ensure diabetes appears in ## Active Health Contexts when confirmed and active.
• Ensure diabetes appears in ## Skill Attachments (Suggested or Active).
• Ensure diabetes.md appears in ## Linked Health Files once created.
• Add or update diabetes-related entries in ## Information Gaps & Follow-up Questions.
• Add provenance and confidence for agent-added facts.

3. Create or Update diabetes.md (Focused Record)

• Create diabetes.md if it does not exist and diabetes is confirmed (or the user explicitly wants diabetes tracking).
• Use diabetes.md for detailed diabetes-specific information that would clutter health.md.
• Keep the file human-readable and structured with stable headings.

4. Ask High-Value Diabetes Follow-up Questions

• Ask only what materially affects guidance or safety.
• Prioritize:
  • diabetes type (if known)
  • severe symptoms / urgent concerns
  • glucose monitoring method and recent readings (if relevant)
  • medications (including insulin and non-insulin diabetes meds)
  • recent HbA1c (if known)
  • care team / clinician follow-up
• Store unanswered questions back in health.md.

5. Keep Advice Context-Aware and Conservative

• Frame answers with diabetes context in mind (and other active contexts in health.md, such as pregnancy).
• Avoid certainty when key details are missing.
• Encourage clinician follow-up for medication changes, insulin dosing changes, and urgent symptoms.

diabetes.md Structure (Recommended)

Use these sections when relevant. Skip sections that do not apply.

# Diabetes Record

## Diabetes Status
- **Status:** Confirmed / Suspected / Resolved
- **Type:** Type 1 / Type 2 / Gestational / Prediabetes / Unspecified
- **Source:** user_reported / clinician_verified / ehr_export / journal_inferred
- **Confidence:** High / Medium / Low
- **Last Confirmed:** YYYY-MM-DD

## Diagnosis and History
- **Diagnosis Date:** YYYY-MM-DD (if known)
- **History Summary:** brief
- **Relevant Complications History:** none / list
- **Other Relevant Conditions:** hypertension, kidney disease, pregnancy, etc.

## Monitoring
- **Monitoring Method:** fingerstick / CGM / none
- **Recent Readings:** optional summary
- **Patterns Noted:** highs/​lows, fasting/​post-meal patterns
- **Last HbA1c:** value + date (if known)

## Medications
- **Insulin:** details (if any)
- **Non-Insulin Diabetes Medications:** details
- **Other Relevant Medications:** optional
- **Medication Questions for Clinician:** list

## Symptoms / Events
- **Current Symptoms:** list
- **Hypoglycemia Episodes:** none / details
- **Hyperglycemia Episodes:** none / details
- **Urgent Symptoms Reported:** none / list

## Care Team and Follow-up
- **Primary Diabetes Clinician:** PCP / Endocrinology / Clinic
- **Next Appointment:** YYYY-MM-DD (if known)
- **Education / Nutrition Support:** optional

## Goals and Self-Management (Optional)
- User goals, clinician-set targets, routines, barriers

## Follow-up Questions
- Open items for future conversations

## Notes
- Free-text notes and clarifications

Sync Rules with health.md

• health.md remains the master health record and index.
• diabetes.md is the detailed companion file.
• When updating diabetes.md, also check whether health.md needs updates in:
  • Active Health Contexts
  • Skill Attachments
  • Linked Health Files
  • Information Gaps & Follow-up Questions
• Keep summaries short in health.md and details in diabetes.md.

Safety Boundaries

• This skill is not reviewed by a medical professional.
• Do not use this skill as a substitute for medical care.
• Escalate possible severe hypoglycemia, severe hyperglycemia, or other urgent symptoms using urgent/​emergency care guidance.
• Do not provide definitive insulin dosing adjustments or medication changes without appropriate clinical confirmation.
• State limitations clearly when diabetes type, medications, or recent readings are unclear.

References

• Read references/​diabetes-record-pattern.md for a canonical diabetes.md template and health.md sync checklist.
• Read references/​diabetes-clinical-grounding.md for current diabetes-focused medical grounding and safety priorities.