diabetestalk.net

Diabetes Annual Review Essential Check

Assessment Of The Patient With Established Diabetes

Assessment Of The Patient With Established Diabetes

Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also the separate Diabetes Education and Self-management Programmes article. When, how and who? Patients with diabetes frequently attend their healthcare practitioners, either specifically for diabetes-related issues, for complications of their chronic illness, or for unrelated problems. They may see their GP, practice nurse, hospital diabetologist, diabetes specialist nurse, dietician and many others, from time to time. Each visit can be viewed as an opportunity to assess and improve the patient's understanding of their illness, and their ability to control the disease. This article provides a summary of the areas of assessment relevant to type 1 diabetes and type 2 diabetes, which will need to be adapted, depending on an individual patient's type of diabetes. Aims of assessing the patient with diabetes To educate the patient and enable them to monitor and manage their diabetes as well as possible. To assess any problems in glycaemic control and address them to improve it. To detect any complications of diabetes and treat them as appropriate. To educate and reinforce healthy lifestyle advice. To assess the patient's overall health and to treat any associated or coincidental illness, physical or mental. To provide support and advice to the patient on how to cope with living with a chronic illness and how they can best alter their lifestyle to maintain their health. A checklist for a routine, annual or opportunistic review of the patient with diabetes History There is much to cover Continue reading >>

Diabetes

Diabetes

Diabetes is a metabolic disorder in which there is persistent hyperglycaemia (raised blood glucose) as a result of defects in pancreatic insulin secretion, insulin action or both, and abnormalities of carbohydrate and lipid metabolism. The number of people with diabetes in the UK is rapidly increasing, and by early 2014 had reached 3.2 million. Diabetes significantly increases the risk of coronary heart disease and stroke. It is also the biggest cause of kidney failure, the leading cause of blindness in adults of working age and a major cause of limb amputation. NICE [CG15] Diagnosis and management of type 1 diabetes in children, young people and adults, 2004 NICE [NG17] Type 1 diabetes in adults: diagnosis and management, 2015 NICE Clinical Knowledge Summaries Diabetes - type 1, 2015. NICE [NG28] Type 2 diabetes in adults: management, 2015 NICE Clinical Knowledge Summaries Diabetes - type 2, 2015 See also Metabolic syndrome Type 1 diabetes Accounts for only 5–15% of people with diabetes No insulin is produced, usually because pancreatic beta-cells are destroyed (autoimmune disease) Rapidly fatal without treatment with insulin Generally diagnosed at a young age Type 2 diabetes Accounts for 85–95% of people with diabetes Large proportion of affected individuals overweight or obese Some but not enough insulin is produced, or the body is resistant to the action of insulin Patients often asymptomatic initially. Long survival without treatment is possible, but diagnosis and treatment essential to minimise complications Generally diagnosed from 3rd decade, but increasingly occurring in younger people Gestational diabetes Hyperglycaemia of variable severity that arises during pregnancy and usually disappears on delivery NICE pathways. Diabetes in pregnancy. Treatment aims Continue reading >>

Empowering Patients With Diabetic Retinopathy

Empowering Patients With Diabetic Retinopathy

Empowering patients with diabetic retinopathy Ophthalmologist & Head of The Reading Centre: NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK Peter Blows, Ophthalmic Image Grader: Moorfields Eye Hospital, London, UK; Copyright 2015 Peter Blows, Tunde Peto and Katlego Mbulawa. This is an Open Access article distributed under the Creative Commons Attribution Non-Commercial License. Knowing how to engage and enthuse patients with diabetes is crucial to preventing blindness due diabetic eye disease, especially taking rising prevalence into account. Whilst treatment methods and facilities vary across the world, the mantra of prevention and empowerment remains constant. This article includes contributions from both a UK and an African screening service to highlight ways to tackle similar challenges. Whatever the setting, it is important to identify and understand the needs of your community. Tower Hamlets in London, for example, has the largest Bangladeshi population in England and both verbal and written information is available in Bengali. Raising awareness is also important. In the Botswana National Programme, activities to raise awareness in the community and in the health care sector include road shows, TV and radio presentations, and the distribution of diabetes pamphlets and small pocket-size cards with helpful contact information. The programme also carries out patient workshops, cardiovascular disease education, diabetes education, consultations and retinal screening. People with diabetes have many appointments to keep, including foot examinations and blood glucose, blood lipids and blood pressure tests. It is important for eye care professionals not assume that patient education has alread Continue reading >>

Essential Annual Diabetes Checks

Essential Annual Diabetes Checks

Once diagnosed with diabetes , the NHS should invite a person for regular check-ups, including an annual diabetes check. Regular check-ups can catch early signs of complications. If you have diabetes then getting key diabetes tests, such as the HbA1c test , a dilated eye examination, and a foot examination, is essential. NHS and Diabetes UK research has found too few people with diabetes are having the health checks and services recommended by the National Institute of Health and Care Excellence (NICE). Here are the tests and services Diabetes UK says diabetes patients should have: There are a number of tests the charity says people with diabetes should be having. You should: Have your blood glucose levels measured at least once a year with an HbA1c blood test. Have your blood pressure measured and recorded at least once a year. Have your cholesterol measured every year. Have your eyes screened for signs of retinopathy every year. Using a specialised digital camera, a photo of each eye should be taken and examined by a specialist who will look for any changes to your retina (the seeing part at the back of your eye). Have the skin , circulation and nerve supply of your legs and feet examined annually. Have your kidney functions monitored annually. You should have two tests for your kidneys : a urine test for protein (a sign of possible kidney problems) and a blood test to measure kidney function. Have your weight checked and have your waist measured to see if you need to lose weight . Children should have more frequent HbA1c measurements and generally do not have formal screening for complications (eg blood pressure , blood fats, eyes , feet and kidneys) until they are 12 years old. However, their weight, height and general health should be regularly monitored. In addit Continue reading >>

Managing Diabetes

Managing Diabetes

Diabetes can be managed by carefully monitoring some key indicators for each individual. NICE recommends that people with diabetes undertake nine annual health checks. It is vital that people with diabetes receive all nine of these key health tests and measures. These checks help to monitor and manage their condition as well as reduce the risk of complications such as stroke, heart disease and amputations. The nine annual health checks for people with diabetes are: weight and body mass index measurements blood pressure smoking status blood test (HbA1c – blood glucose levels) urinary albumin test (or protein test to measure the kidney function) serum creatinine test (creatinine is an indicator for renal function) cholesterol levels eye check (retinopathy screening) feet check. In addition to the nine annual health checks, Diabetes UK has identified '15 Healthcare Essentials'. These have been highlighted so that people with diabetes and health care workers know what care people with diabetes should expect. These 'Healthcare Essentials' should also be undertaken annually or as required in the case of specialist care needs. The '15 Healthcare Essentials' can be considered under four categories of: blood tests physical checks advice and support specialist care. Explore the interactivity below to see how the '15 Healthcare Essentials' fit into these four categories. What is a good blood glucose level? NICE guidelines for the UK currently recommend the following: The target blood glucose ranges below are indicated as a guide. Children with Type 1 diabetes (NICE 2015) • on waking and before meals: 4–7mmol/l • after meals: 5–9mmol/l. Adults with Type 1 diabetes (NICE 2015) • on waking: 5–7mmol/l • before meals at other times of the day: 4–7mmol/l • 90 minutes Continue reading >>

:: Leicestershire Diabetes :: Annual Review

:: Leicestershire Diabetes :: Annual Review

Home / Guide to Diabetes / YourCare / AnnualReview It is essential that your diabetes is reviewed yearly by your diabetes team.Appointments should be sent to you from your diabetes team, it is important that you do attend the clinics. This is to ensure that your treatment is correct and your target diabetes levels are being obtained between 4 - 7 mmol/l and to prevent the onset of diabetes complications. Expect your diabetes to be reviewed yearly. It is important that your nurse or doctor reviews your diabetes and its treatment on a regular basis. There are many ways that your doctor can check whether you are developing Diabetic Complications with your: Feet, Eyes, Heart, Kidneys, Circulation, and Nervous System. Therefore it is important that you have your yearly MOT / Annual Review. It is essential that you attend your annual review appointment so that we can catch any potential problems early on hence It is very important that you attend. The following will be checked Blood Tests: for your blood fats and HbA1c (which your long term diabetes check) and your kidneys Foot Check with the podiatrist including pulses and sensation Eye check (with your optician or optometrist) Urine test(You will be asked to bring a sample with you.) The diabetes team will take a blood sample from your arm. During the life of a red blood cell (8-12 weeks) sugar sticks to part of it. This blood test gives an overview of the level of your blood sugars over the last 2-3 months. This will inform your diabetes team as to the level of your diabetes control. HbA1c Target Level To show good diabetes control the HbA1c result should be between 6.5-7.5% where 7% is the ideal target. Ways to reduce your HbA1c Always ask your diabetes team what your HbA1c result was, and by comparing it with previous r Continue reading >>

Diabetes Health Checks

Diabetes Health Checks

Health checks are good practice for diabetes management To ensure we stay healthy, as people with diabetes, we should undergo a number of important health checks each year. Some of the checks are ones which we should receive at least once each year and others are dependent on specific circumstances. The following health checks are ones which all people with diabetes should receive once a year. The one exception to this rule is children under 12 years old. Blood glucose control check HbA1c test This may be carried out either via a blood sample taken from your arm, or if it is the only blood check, via a finger prick test. This test requires a blood sample from your arm. Blood samples will usually require you to arrange for the blood test to be taken at least a couple of weeks before your annual diabetic care review. Check with your health team if you need more information about the process. Two different tests are carried out to check for kidney problems. For the first check, a urine sample is needed. Ideally you should bring your urine sample with you to your diabetic care review. The urine test looks for the presence of protein in the urine. No protein in the urine is a good sign. The second check is done via a blood sample which checks the glomerular filtration rate of the kidneys; in other words, how well the kidneys are functioning. Your blood pressure will usually be measured at your clinic or diabetic care review. The test is not complicated but you will need to be in a rested state whilst your blood pressure is being checked to prevent the reading being higher than it should be. Peoples blood pressure can rise in a short space of time and the doctor or nurse may need to repeat the test if a high reading is recorded. Each year you should be offered a retinopathy Continue reading >>

15 Healthcare Essentials - The Care You Should Expect

15 Healthcare Essentials - The Care You Should Expect

15 healthcare essentials - the care you should expect 15 healthcare essentials - the care you should expect Having the right care is essential for the wellbeing of all people with diabetes. As well as looking after yourself, there are 15 vital checks and services that everyone with diabetes should get for free from their healthcare team the 15 healthcare essentials . You can use this list to talk to your healthcare team about your individual needs as part of your annual care planning review. This is where you should agree your priorities, discuss your personal targets and agree a written plan of action to help you reach them. The 15 Healthcare Essentials is the minimum level of healthcare everyone with diabetes deserves and should expect. You can use this list to talk to your healthcare team about your individual needs as part of your annual care planning review. This is where you should agree your priorities, discuss your personal targets and agree a written plan of action to help you reach them. If you aren't getting all the care you deserve, take the 15 healthcare essentials checklist (PDF, 65KB)to your diabetes healthcare team and discuss it with them. What to do if you're not receiving your essential checks If you have any questions or concerns about your checks, or if there are any checks you are not receiving, it is important to discuss this with your doctor or healthcare professional. Our guide, Are You Really Getting Your 15 ? (PDF, 219KB) tells you what each check should look like, and has tips for what you can do if there are any health checks you haven't had this year. Maybe you've been waiting a long time for your diabetes check up, are having problems arranging an appointment, or are not getting all the checks you should be. You might find it helpful to t Continue reading >>

Following Up People With Diabetes

Following Up People With Diabetes

You can download the full Audit for printing, or for your convenience you can download and print only the data sheet sections to fill out. Regular health checks are essential for people with diabetes in order to reduce the frequency and long-term impact of complications. Previously, monitoring of diabetes was supported by the Get Checked programme, which offered free annual health reviews to people with diabetes. This has been replaced by the Diabetes Care Improvement Package. This change has meant that the provision of care for people with diabetes is determined by individual DHBs and is less standardised across the country. The needs of individual patients have not changed, however, and every person with diabetes should still receive regular testing and monitoring to ensure that the progression of the disease and its complications is halted or slowed. The annual follow-up of individuals with diabetes is also currently a PHO Performance Programme (PPP) indicator. The PPP goal as of Oct 2013 (check for updates) is for at least 80% of all people with diabetes enrolled in a practice to have had a full review once per year, and this includes both laboratory testing and clinical examination. This audit aims to aid clinicians in their follow-up of their patient population with diabetes, by assessing appropriate laboratory testing, which is one part of the recommended annual review. For further information on performing a diabetes follow-up, see: Diabetes follow-up: what are the PHO performance indicators and how are they best achieved? , BPJ 39 (Oct, 2011). The regular follow-up of people with diabetes should include the laboratory assessment of: Renal health using urinary albumin/creatinine ratio and serum creatinine HbA1c is used to monitor glycaemic control in people wit Continue reading >>

Danes Camp Medical Centre - Diabetes

Danes Camp Medical Centre - Diabetes

Diabetic Care Annual Diabetic Check All of our patients are invited by letter to attend the diabetic clinic once a year for an annual review with a practice nurse, who has received additional specialist training in diabetic care. Two weeks prior to this appointment please attend surgery to see Eleanor, our Health Care Assistant, for a fasting blood test (Kidney and liver function, cholesterol and a test that assesses control of blood sugar over the past few months). The results will then be ready for discussion at your annual review. All diabetic patients should be screened annually at the retinopathyclinic. You will be sentan invitation letter informing youwhen your appointment.If you receive an invitation then it is very important that you attend as this will be your only annual opportunity to have the screening. Please do not ignore your recall for annual review. If you are house bound then please let Carolyn Coulton know and she will make alternative arrangements for you. Northampton clinical waste department provide a confidential clinical waste collection service Tel: 01604 838281. Diabetes Mellitus (sugar diabetes) is a very common condition affecting about ? of the population. It occurs when the body does not produce enough insulin to regulate the level of sugar in the blood. For those affected by diabetes it can be controlled, dependent on the type of diabetes it is, by diet, diet and tablets or by insulin. Irrespective of the type of diabetes complications can occur. All diabetics have an increased risk of heart disease, kidney problems, eye damage which could lead to blindness and damage to nerves and blood vessels (especially in the feet) which can lead to ulcers and other foot complications. However in the majority of patients, if diabetes is well controll Continue reading >>

Set: Diabetic Cooking Essentials - Quick & Easy

Set: Diabetic Cooking Essentials - Quick & Easy

View your full shopping cart for taxes and shipping. SET: Diabetic Cooking Essentials - Quick & Easy With over 550 recipes, this trio of quick & easy meals for you and your family means you'll save time and money by eating healthy meals at home. Includes a FREE copy of The Official Pocket Guide to Diabetic Food Choices. Diabetic Cooking Essentials - Quick & Easy! With over 550 recipes, this trio of quick & easy meals for you and your family means you'll save time and money by eating healthy meals at home. Quick & Healthy Recipes and Ideas, 3rd ed.- Designed for anyone who wants to eat healthier but doesnt have a lot of time,Quick & Healthy Recipes and Ideasoffers 200 easy recipes and a wealth of nutrition and time-saving tips; delicious, quick-to-prepare, low-fat recipes; and 20 weeks of easy menus - each with a grocery list! The 4-Ingredients Diabetes Cookbook -Making delicious meals doesn't have to be complicated, time-consuming, or expensive. You can create satisfying dishes using just four ingredients, or even less! Make the most of your time and money.With over 150 quick, easy-to-prepare recipe, you'll be amazed at how much you can prepare with just a few simple ingredients. Official Pocket Guide to Diabetic Food Choices-Now people with diabetes can take the Food Lists with them to the grocery store or to restaurants with the Official Pocket Guide to Diabetic Food Choices, 4th Edition.Measuring just 3.75" x 6", this little powerhouse is jam-packed with the exact same information found in the standard exchange lists, yet it fits conveniently into a purse or coat pocket. Continue reading >>

Screening And Regular Checks

Screening And Regular Checks

To help you keep well and healthy and keep control of your diabetes you need regular and effective healthcare. Routine health care for people with diabetes aims to support you to look after your diabetes yourself. To get the best possible care it is important that you work with your healthcare team. You and the healthcare team need to combine your expertise and experience to agree the care and support you need. Regular reviews are an essential part of your diabetes healthcare. Regular reviews in uncomplicated stable people with diabetes can be carried out 6 monthly. More frequent reviews are required if there are either extra risk factors, you develop diabetes related complications or you are finding it difficult to control your diabetes. Each routine review should include checking: Weight & BMI Review of home monitoring results if applicable Blood pressure Diabetes management review Review current drug therapy Additionally the following should be checked at least once a year Eyes screened for Diabetic Retinopathy Feet Urine checked for signs of kidney disease Blood tests to check for signs of kidney disease and to check cholesterol levels If relevant the following may also be included in a diabetic review Examination of injection sites where relevant Diet and nutrition Education update Sexual Health Smoking Alcohol consumption Psychological wellbeing and depression Pre conception counselling Advice on access to other services Each review should be a discussion between you and your healthcare team – Remember, you are part of that team! We want to encourage you to come to each review prepared and ready to review your diabetes. If it helps you, then make notes before, during and after the review. If necessary ask the doctor to write things down for you or give you infor Continue reading >>

Check Ups

Check Ups

What type 1 checks you should be having on a regular basis? The amount of care you receive can seem daunting at first, but it might not be as much trouble as you might expect. Here are the check ups you should be receiving and how often it’s recommended to get them done. Blood and urine test What it is: These tests will measure a number of things, including liver and kidney function, cholesterol and your HbA1c level (your average blood glucose level over the last three months). How often do you need it: At least once a year, but four to six months is recommended. Children should have this done every four months. Type 1 diabetes check up What it is: Your height, weight and blood pressure will be taken, and the results of your blood and urine tests will be discussed in this appointment. This is where you can discuss any other problems or concerns you have about your type 1 diabetes. How often you need it: It is recommended that you make this appointment around a week after your blood and urine test (so same frequency applies). Eye screening What it is: A specialist will take a photo of each eye to look for any changes to your retina (the seeing part at the back of your eye). This is different to a regular optician appointment, as they will be looking for signs of retinopathy. How often you need it: You should receive an invitation to an appointment every year. Foot check up What it is: A trained professional will check your legs and feet for any numbness, poor circulation, corns, calluses, nail problems and other conditions. They will discuss whether you are at risk of developing any foot problems and, if necessary, you may referred to a foot specialist (a podiatrist). How often you need it: It is recommended that you have an annual foot check. If you aren’t offered, 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 Checks Among Indicators Proposed For Latest Nice Qof Menu

Annual Diabetes Checks Among Indicators Proposed For Latest Nice Qof Menu

Annual diabetes checks among indicators proposed for latest NICE QOF menu A series of annual checks to monitor and improve the health of people with diabetes are among measures proposed by NICE for its latest Quality and Outcomes Framework (QOF) indicator menu. The QOF is a voluntary incentive scheme for GP practices in the UK, rewarding them for how well they care for their patients, and helping them target resources for where they are most needed. It consists of groups of indicators against which practices score points according to their level of achievement. NHS England, and health administrations from Northern Ireland, Scotland and Wales, can use NICEs QOF menu to determine which indicators are used within the QOF within their own countries. For the latest QOF menu , NICE proposes a bundled indicator of eight checks for people with diabetes. Around 3.2 million people are diagnosed with diabetes in the UK, with numbers of people diagnosed with the condition increasing sharply in the last year. NICE recommends that people with diabetes should receive annual health checks to monitor and manage their condition, as well as reduce the risk of complications associated with the condition, such as heart disease and amputations. However, NHS figures suggest less than 10 per cent of people are being offered the full series of tests recommended by NICE in some areas of England. To address this, the latest QOF menu proposed by NICE includes an indicator that measures the percentage of people with diabetes who have the following care processes performed in the preceding 12 months: The latest NICE QOF menu also includes three new indicators to support high quality care for people with newly diagnosed hypertension. NICE says that it is important to assess target organ damage, as t Continue reading >>

More in diabetes