We operate a call and recall system for patients on our diabetes register. Our service aim is to control the patient's diabetes.
Many patients have diabetes that can be controlled by diet alone or with medication. Some patients require insulin. Insulin dependent patients are usually seen , at least in the first instance at a hospital outpatient clinic.
We conduct physical examinations in our diabetes clinic. This includes height & weight checks. This allows calculation of body mass index (BMI). This should be between 20 and 25. We also check blood pressure. Whilst a normal BP would be considered 120/80 mmHg, patients are advised of a target for their individual situation.
Foot examinations are conducted to check skin and sensation. Eyes are checked by digital retinal photography. A special unit visits the practice so patients can be seen at their own surgery where that is where they are being monitored. Patients are asked to look at a reading chart and drops are inserted into the eye to enlarge pupils. The effect of the drops can last up to two hours so it is unsafe to drive until the effect of the drops has worn off. Where a patient is on insulin, the site of the injections is checked.
From time to time, laboratory tests are undertaken - including haemaglobin HbA1c monitoring. This allows diabetes control to be monitored. Creatinine and eGFR are also checked to see how well kidneys are performing. A lipid profile is also obtained. Liver function tests are also undertaken to monitor fat deposition and ensure that this is not upsetting the liver. Urine samples allow microalbumin to be monitored so that complications of diabetes can be avoided.
Where possible, tests are undertaken before appointments so that the results are available at the review where general well-being, current treatment, diabetes control and any problems arising are discussed. Referrals to podiatrist or dietitian are also considered, where required. Details of diabetes clinics can be obtained from our reception.