The purpose of the Diabetes Service is for problem solving of diabetes care and related problems, providing a plan and then discharge back to primary care. These clinics are not for routine care of uncomplicated diabetes. Sometimes, particularly with type 1 diabetes, longer term follow up to provide complex specialist diabetes care may be required.
Routine diabetes care, such as annual diabetes complication reviews, is not provided by the specialist service and primary care must continue to provide this, even in patients under long term specialist care.
Indications for referral to these clinics include:
- Type 2 diabetes on maximal hypoglycaemic therapy requiring assessment for additional therapies or insulin e.g. failure to achieve HbA1c 58mmol/mol despite maximal lifestyle measures.
- In type 1 or insulin-treated type 2 diabetes, failure to achieve glycaemic targets despite all reasonable attempts.
- Recurrent or severe hypoglycaemia, hypoglycaemia unawareness.
- Diabetes due to other causes e.g. pancreatitis, genetic syndromes.
- Concerns about diagnosis or classification of diabetes.
- Poorly controlled blood pressure in diabetes despite three or more medications.
- Lipid problems in diabetes.
- Obesity in diabetes.
- Neurological problems in diabetes including painful neuropathy, gastroparesis and any other diabetes related complications.
- Renal impairment, proteinuria & nephropathy in diabetes.
- Medication problems in diabetes e.g. multiple intolerance of oral agents, insulin allergy.
- Patients on insulin pumps transferring from other centres.
- Patients requesting information regarding flash or continuous glucose monitoring systems.
- Psychosocial or other issues coping with diabetes.
It is helpful if you can prepare for all of your appointments with the Diabetes Service by:
1) Thinking about what you would like to discuss in your diabetes appointment.
2) Ensuring you know what current medications and doses you are taking.
3) Bringing your blood glucose meter to clinic.
4) Uploading the data from your insulin pump and/or continuous glucose monitor ahead of your appointment (if applicable).