...How should a DM patient be followed from a cardiac standpoint (e.g. EKGs, echos, etc.)? 

Note: An example of a serious cardiac problem would include a very rapid or very slow heartbeat, or arrhythmia (irregular heartbeat).

The patient should have EKG, echo and electrophysiological (EP) studies, depending on the nature of arrhythmia to determine the need for a pacemaker. If a pacemaker needs to be implanted, a device with pacemaker/defibrillator capability may be preferable.