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6 Monthly Diabetic Review

Diabetes - Tests And Checkups

Diabetes - Tests And Checkups

See your diabetes doctor for an exam every 3 to 6 months. During this exam, your doctor should check your: Blood pressure Weight Feet See your dentist every 6 months, also. Your doctor should check the pulses in your feet and your reflexes at least once a year. Your doctor should also look for: If you have had foot ulcers before, see your doctor every 3 to 6 months. It is always a good idea to ask your doctor to check your feet. An A1c lab test shows how well you are controlling your blood sugar levels over a 3-month period. The normal level is less than 5.7%. Most people with diabetes should aim for an A1C of less than 7%. Some people have a higher target. Your doctor will help decide what your target should be. Higher A1C numbers mean that your blood sugar is higher and that you may be more likely to have complications from your diabetes. Continue reading >>

The A1c Test & Diabetes

The A1c Test & Diabetes

What is the A1C test? The A1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past 3 months. The A1C test is sometimes called the hemoglobin A1c, HbA1c, or glycohemoglobin test. The A1C test is the primary test used for diabetes management and diabetes research. How does the A1C test work? The A1C test is based on the attachment of glucose to hemoglobin, the protein in red blood cells that carries oxygen. In the body, red blood cells are constantly forming and dying, but typically they live for about 3 months. Thus, the A1C test reflects the average of a person’s blood glucose levels over the past 3 months. The A1C test result is reported as a percentage. The higher the percentage, the higher a person’s blood glucose levels have been. A normal A1C level is below 5.7 percent. Can the A1C test be used to diagnose type 2 diabetes and prediabetes? Yes. In 2009, an international expert committee recommended the A1C test as one of the tests available to help diagnose type 2 diabetes and prediabetes.1 Previously, only the traditional blood glucose tests were used to diagnose diabetes and prediabetes. Because the A1C test does not require fasting and blood can be drawn for the test at any time of day, experts are hoping its convenience will allow more people to get tested—thus, decreasing the number of people with undiagnosed diabetes. However, some medical organizations continue to recommend using blood glucose tests for diagnosis. Why should a person be tested for diabetes? Testing is especially important because early in the disease diabetes has no symptoms. Although no test is perfect, the A1C and blood glucose tests are the best tools available to diagnose diabetes—a serious and li Continue reading >>

Diabetes Annual Care Review

Diabetes Annual Care Review

You should have a review with your doctor at least once a year All people with diabetes should undergo a diabetes care review at least once annually. Your diabetic review will allow your doctors to monitor your health. They will also use your annual review to assess aspects such as your long term blood glucose control , cholesterol levels and blood pressure . Some people, such as those newly diagnosed, children , or those with complications present may have a diabetic review more often than annually. At your annual diabetes care review the doctor or nurse will: Take your height and weight (to check if you are under or overweight) Review your HbA1c and cholesterol levels Discuss any issues you have with your diabetes or health in general Advise any change in regime, lifestyle or medication - including any side effects People who take insulin should also have their injection or infusion sites checked. You may also be asked whether you are suffering from depression or sexual dysfunction , as these tend to be more common in people with diabetes. It can be helpful to know what results you should be aiming for. For this reason we have put together a page to cover the targets you should be aiming for. Read more about diabetes health guidelines Diabetes retinopathy screening and having your feet examined are part of your annual review, however, you may need to book separate appointments for these depending on how your practice organises these. Your general eyesight should be checked either at your annual review or as part of your retinopathy screening appointment. For more information on retinopathy screening and foot examinations, see our diabetes health screening pages. You will usually need to book a blood test appointment about a couple of weeks prior to the annual review. Continue reading >>

Annual Diabetes Review

Annual Diabetes Review

This site is intended for healthcare professionals Three-monthly during first year, then six-monthly, check: current health, medication and compliance history of hypo- and hyperglycaemic episodes BP pulse weight and BMI (& height if no record) Annual audit same as three/six-monthly monitoring plus: lifestyle assessment (alcohol, smoking etc) if persists, start ACE inhibitor as per BNF guidance macrovascular examination (heart, carotids, peripheral circulation) The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions. Copyright 2016 Oxbridge Solutions Ltd. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions Ltd receives funding from advertising but maintains editorial independence. GPnotebook stores small data files on your computer called cookies so that we can recognise you and provide you with the best service. If you do not want to receive cookies please do not use GPnotebook. Continue reading >>

Important Changes To The Ndss

Important Changes To The Ndss

For information about access to continuous glucose monitoring products through the NDSS, go to ndss.com.au/cgm Important notice about NDSS product supply and delivery There have been changes to the way NDSS products are supplied and delivered. What this means for people with diabetes: Consumers will now receive all NDSS products, including insulin pump consumables (IPCs), through NDSS Access Points, usually your local community pharmacy. If you do not know where your nearest NDSS community pharmacy is located, you can check on the NDSS website at ndss.com.au or call the NDSS Helpline on 1300 136 588. Changes to the NDSS The Australian Government implemented changes to the NDSS from 1 July, 2016. Under these changes, NDSS products are no longer distributed through Diabetes Australia and state and territory diabetes organisations. Diabetes Australia and state and territory diabetes organisations will continue to deliver NDSS support and education services for people living with all types of diabetes. From 1 July 2016, NDSS products, such as needles, syringes, blood glucose test strips and urine test strips will be available from NDSS Access Points, usually your local community pharmacy. In addition, insulin pump consumables are now available from Access Points. If an Access Point does not stock the product, they can be ordered by and delivered to the Access Point, usually within 24-48 hours. People using an insulin pump are encouraged to speak to their local Access Point about their requirements. The Australian Government has also made changes to access to subsidised test strips for people with type 2 diabetes who do not use insulin. From 1 July 2016, all people with type 2 diabetes who are not using insulin can purchase subsidised blood glucose testing strips for an init Continue reading >>

Check-ups | Diabetes Uk

Check-ups | Diabetes Uk

your weight and height should be measured to make sure youre a healthy weight for your height and see that you're growing at the right rateyour weight and height should be measured to make sure youre a healthy weight for your height and see that you're growing at the right rate your injection sites should be examinedyour injection sites should be examined your blood should be tested to measure long-term diabetes control (the test is called HbA1c)your blood should be tested to measure long-term diabetes control (the test is called HbA1c) a test for thyroid function and coeliac disease may also be done.a test for thyroid function and coeliac disease may also be done. your legs and feet should be examined to check your circulation and nerve supply urine and blood tests shuld be done to make sure your kidneys are working properly your blood pressure should be checked to make sure your heart is working properly your retina (back of your eye) should be photographed using a digital camera. See the complications section of this site for more information. Someone is diagnosed with diabetes every two minutes. Your donation can change lives. Continue reading >>

Tests For Blood Sugar (glucose) And Hba1c

Tests For Blood Sugar (glucose) And Hba1c

Blood sugar (glucose) measurements are used to diagnose diabetes. They are also used to monitor glucose control for those people who are already known to have diabetes. Play VideoPlayMute0:00/0:00Loaded: 0%Progress: 0%Stream TypeLIVE0:00Playback Rate1xChapters Chapters Descriptions descriptions off, selected Subtitles undefined settings, opens undefined settings dialog captions and subtitles off, selected Audio TrackFullscreen This is a modal window. Beginning of dialog window. Escape will cancel and close the window. TextColorWhiteBlackRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentBackgroundColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentTransparentWindowColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyTransparentSemi-TransparentOpaqueFont Size50%75%100%125%150%175%200%300%400%Text Edge StyleNoneRaisedDepressedUniformDropshadowFont FamilyProportional Sans-SerifMonospace Sans-SerifProportional SerifMonospace SerifCasualScriptSmall CapsReset restore all settings to the default valuesDoneClose Modal Dialog End of dialog window. If your glucose level remains high then you have diabetes. If the level goes too low then it is called hypoglycaemia. The main tests for measuring the amount of glucose in the blood are: Random blood glucose level. Fasting blood glucose level. The HbA1c blood test. Oral glucose tolerance test. Capillary blood glucose (home monitoring). Urine test for blood sugar (glucose). Blood tests for blood sugar (glucose) Random blood glucose level A sample of blood taken at any time can be a useful test if diabetes is suspected. A level of 11.1 mmol/L or more in the blood sample indicates that you have diabetes. A fasting blood glucose test may be done to confirm the diagnosis. Fasting blood glucose level Continue reading >>

Annual Diabetes Review

Annual Diabetes Review

This report uses data from the pharmaceutical collection and laboratory claims collection to provide an update on diabetes monitoring between March, 2014 and March, 2015 in general practice in New Zealand. View / Download pdf version of this report It is estimated that approximately 257,000 people have diagnosed diabetes in New Zealand.1 An annual diabetes review allows for assessment of glycaemic control and earlier detection of, and intervention for, diabetes related complications. It also creates an opportunity to regularly review and assess individual treatment plans and enable support if required. Additionally, the information gained from diabetes follow-up provides up to date data for diabetes registers, which in turn drives improvements in diabetes service delivery.2 Each DHB is responsible for their own diabetes care improvement package, which is a community and primary care-based programme and therefore services and initiatives differ between regions. Regular checks for the management of diabetes The New Zealand quality standards for diabetes care state that: "People with diabetes should be offered, as a minimum, an annual assessment for the risk and presence of diabetes-related complications and for cardiovascular risk. They should participate in making their own care plans, and set agreed and documented goals/targets with their health care team." 3 The table below suggests the assessments that should be conducted at least annually. The frequency of these may vary depending on the individual patients risk of complications.2,5 Increasing uptake of the annual diabetes review 4 Strategies to increase the number of people with diabetes who receive annual follow-ups include: Send out a recall letter or create an electronic alert: Recall alerts can be created for p Continue reading >>

Ttype 2 Diabetes In Adultsype 2 Diabetes In Adults

Ttype 2 Diabetes In Adultsype 2 Diabetes In Adults

Information for the public About this informationAbout this information NICE guidelines proNICE guidelines provide advice on the care and support that should be offered to people whovide advice on the care and support that should be offered to people who use health and care services.use health and care services. This information explains the advice about type 2 diabetes in adults that is set out in NICE guideline NG28. This is an update of advice on type 2 diabetes in adults that NICE produced in 2009, and replaces it. Does this information apply to me? Yes, if you are an adult (18 or over) with type 2 diabetes. What is typeWhat is type 2 diabetes?2 diabetes? People with diabetes have too much glucose (sugar) in their blood. There are 2 main types of diabetes: type 1 and type 2. Type 2 diabetes is the most common: 9 out of 10 people who have diabetes have type 2 diabetes. It usually starts after the age of 40, but it can affect younger people as well. The body produces a hormone called insulin, which controls how much glucose is in the blood. In type 2 diabetes the body doesn't produce enough insulin, so blood glucose levels become too high. People with type 2 diabetes have an increased risk of problems with their blood vessels and heart (cardiovascular disease). This means that they have an increased risk of having angina, a heart © NICE 2015. All rights reserved. Page 1 of 18 attack or a stroke, especially if they have high blood pressure and high cholesterol. People with type 2 diabetes also have an increased risk of other long-term health problems. These include conditions affecting the eyes, feet, nerves and kidneys. If you have type 2 diabetes it is important to keep your blood glucose levels as close to normal as possible and to have a healthy lifestyle, to re Continue reading >>

My Site - Chapter 9: Monitoring Glycemic Control

My Site - Chapter 9: Monitoring Glycemic Control

Glycated hemoglobin (A1C) is a valuable indicator of glycemic treatment effectiveness and should be measured at least every 3 months when glycemic targets are not being met and when antihyperglycemic therapy is being adjusted. In some circumstances, such as when significant changes are made to therapy or during pregnancy, it is appropriate to check A1C more frequently. Awareness of all measures of glycemiaself-monitored blood glucose results, including self-monitored blood glucose (SMBG), flash glucose monitoring (FGM), continous glucose monitoring (CGM) and A1Cprovides the best information to assess glycemic control. Self-monitoring of blood glucose, FGM and CGM should not be viewed as glucose-lowering interventions, but rather as aids to assess the effectiveness of glucose-lowering interventions and to prevent and detect hypoglycemia. Timing and frequency of SMBG may be determined individually based on the type of diabetes, the type of antihyperglycemic treatment prescribed, the need for information about blood glucose levels and the individual's capacity to use the information from testing to modify healthy behaviours or self-adjust antihyperglycemic agents. SMBG, FGM and CGM linked with a structured educational and therapeutic program designed to facilitate behaviour change can improve blood glucose levels and prevent hypoglycemia. A1C is a measurement of your average blood glucose control for the last 2 to 3 months. Approximately 50% of the value comes from the last 30 days. You should have your A1C measured every 3 months when your blood glucose targets are not being met or when you are making changes to your diabetes management. In some circumstances, such as when significant changes are made to your glucose-lowering therapy or during pregnancy, your health-care Continue reading >>

Standards Of Medical Care For Patients With Diabetes Mellitus

Standards Of Medical Care For Patients With Diabetes Mellitus

Diabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested persons with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Skyler (Ed.): Medical Management of Type 1 Diabetes (1) and Zimmerman (Ed.): Medical Management of Type 2 Diabetes (2). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E. CLASSIFICATION, DIAGNOSIS, AND SCREENING Classification In 1997, the ADA issued new diagnostic and classification criteria (3). The classification of diabetes mellitus includes four clinical classes: Type 1 diabetes (results from β Continue reading >>

Testing For Diabetes: What Your Hba1c Levels Mean

Testing For Diabetes: What Your Hba1c Levels Mean

Testing for diabetes: what your HbA1c levels mean The test for Type 2 diabetes is quick and easyCredit:Tom Merton The basic tests to diagnose Type 2 diabetes are effective and very fast. However, often the illness is first diagnosed by chance, when a patient is being tested for something else. That was certainly true for 48-year-old Stacy Evans, a father of three, who works in sales in Milton Keynes. Evans, whose partner Debbie Barks, 51, works for the NHS, says: In 2012, I went to register with a new GP and had a urine test as part of the process. I didnt know anything about type 2 diabetes so wasnt then aware of having any symptoms. But my blood sugar readings were off the scale, apparently. "As I learnt about the disease, I realised that not only was I at high risk, as I was massively overweight and unfit, but also I was exhibiting classic symptoms. I needed to go to the toilet three or four times a night, for example. Other symptoms include a constant thirst, weight loss and excessive tiredness. Stacy Evans, 48, was diagnosed with Type 2 diabetes in 2012Credit:Rii Schroer/The Telegraph Evans was so unaware of what type 2 diabetes meant he wasnt even shocked. I had no idea how serious it could be. He later learnt that the condition which occurs when the body is unable to produce enough insulin or unable to use what insulin it does produce to control blood sugar levels can have serious consequences, including organ damage and coma. Healthy blood sugar levels from a diabetes test should be between 4.0 to 6.0 mmol/L (millimoles per litre) when fasting or up to 7.8 mmol/L two hours after eating a meal, according to the NHS. But when doctors took Evanss blood, they calculated his blood sugar levels at 17mmol/l. Evans was immediately put on to medication that makes the bo Continue reading >>

Six-monthly Hba1c Tests In Diabetes 'unnecessary'

Six-monthly Hba1c Tests In Diabetes 'unnecessary'

Six-monthly HbA1c tests in diabetes 'unnecessary' GPs do not need to test blood glucose in patients with stable diabetes every six months, as recommended by NICE, as it leads to a high rate of false positives an NHS report has concluded. Annual monitoring would give more meaningful information on changes to HbA1c which for most people happen quite slowly, the NHS Diabetes report said. Statistical modelling showed for patients whose HbA1c is currently 56mmol/mol, six-monthly monitoring would pick up 405 positive tests per 1,000 patients that is HbAlc readings above 58.5 mmol/mol - but 28% of those would be due to measurement variation and not a real increase. For the same group of patients annual monitoring would pick up 479 per 1,000 patients but with only 16% would be false positives, the University of Oxford researchers who did the analysis found. In other groups with lower starting HbA1c readings most of the positive tests seen with six-monthly tests would be false positives, the report said. For someone with a starting HbA1c, a positive test six months later has a 64% chance of being false compared with 31% after a year, the figures showed. For many people with diabetes, six-monthly monitoring is more likely to yield a false-positive test attributable to the within-measurement variability of HbA1c than a true-positive test, attributable to the change over time in glycaemic control, the researchers concluded. Annual monitoring gives more time for a meaningful change to occur in HbA1c. The team added that high rates of false-positive tests mean prescribing decisions, such as a dose increase or an additional medication, being made the basis of a chance finding rather than a true change. Professor Roger Gadsby, a GP and associate clinical professor at Warwick Medical S Continue reading >>

Changes To Access To Blood Glucose Test Strips

Changes To Access To Blood Glucose Test Strips

Information relating to the changes to access to blood glucose test strips The Australian Government has introduced changes to the National Diabetes Services Scheme (NDSS) to ensure people living with diabetes can continue to access the products they need as well as ensuring the ongoing sustainability of the NDSS. This includes changes to access to subsidised blood glucose test strips. If a doctor, credentialed diabetes educator, or nurse practitioner wants their patient to use blood glucose test strips in managing their diabetes, they will be able to access them from the NDSS. Access to Blood Glucose Test Strips Through the NDSS People with type 2 diabetes not using insulin will receive an initial six month supply of subsidised blood glucose test strips under the NDSS. This means registrants will be able to access blood glucose test strips, as required, over a six month period, starting any time on or after 1 July 2016. After six months, registrants will be able to continue to access subsidised test strips if their doctor, nurse practitioner or credentialed diabetes educator considers that there is a clinical need for them to continue to monitor their blood glucose levels. The initial six month access period applies to both new and existing NDSS registrants. Where a registrant has been accessing test strips for several years, their six month initial access period will commence from their first order of test strips on or after 1 July 2016. These changes to do not affect individuals who use insulin, women with gestational diabetes and those registered through the NDSS as having ‘other diabetes’. Individuals with type 2 diabetes, who are not using insulin, but who have an inter-current illness or are taking medicines which adversely impact blood glucose control, will Continue reading >>

3 Diabetes Tests You Must Have

3 Diabetes Tests You Must Have

Mike Ellis was fly fishing when he first noticed a change in his vision. Ellis, an avid angler, had so much trouble focusing he struggled for 20 minutes before he was finally able to get a fly on his hook, something he'd done countless times over many years of fly fishing. Then, after casting his line, he was unable to see his lure on the water. "I thought I'd scorched my eyeballs from being out in the sun too much," says Ellis, 63, a retired mechanical engineer in Denver. An eye exam the following month revealed an equally unsettling reality: Ellis had type 2 diabetes, the most common type of the disease. Years of going undiagnosed had taken a toll on his eyesight. He had diabetic retinopathy. The blood vessels in the back of his eye were damaged, a problem that often comes with the condition. "Diabetes damages every blood vessel in your body, including the ones in your eyes," says Robert Rizza, MD, professor of medicine at the Mayo Clinic. "Similar damage can also occur in your heart, your head, and your kidneys. But if you take care of yourself -- if you control your blood sugar, blood cholesterol, and blood pressure -- the chances of bad things happening to you are very low." Certainly, that's the case with Ellis. With the help of three basic tests, he has his diabetes in check. These tests can help you, too. A simple blood test, the A1c (your doctor may call it "glycosylated hemoglobin") is done on a sample of blood taken from a finger-stick or from a small vial of it drawn from your arm. Not to be confused with the daily at-home monitoring that allows some people with diabetes to measure their blood sugars in the moment, the A1c test paints a picture of your average blood sugar level for the past 3 months. If you can keep your hemoglobin A1c in the range of about Continue reading >>

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