Diabetes and Your Part in Your Own Care

Effective Diabetes care is achieved by Teamwork between you and your diabetes care team.

Looking after your diabetes and changing lifestyle to fit in with the demands of diabetes is hard work but you’re worth it.

Ask questions and request information.  Take control!! The more you know about your own diabetes the easier this will become.

Please attend your scheduled appointments and inform the practice team if you are unable to do so.

Please ensure that you are well informed about your diabetes. We recommend that you regularly keep yourself up to date about diabetes by viewing www.diabetes.org.uk

The following information relates to the care we provide at Munro Medical Centre. Once again, we encourage you to find out as much as possible about diabetes on www.diabetes.org.uk

You will have a thorough assessment of your diabetes at diagnosis, and then invited annually. Patients with control that could be better will be asked to have a blood test twice yearly, and may be asked to attend the surgery in between the annual review. The blood test will always check your Hba1C.

Hba1C

We recommend that you keep a note of your Hba1C.
Please ask at your diabetes appointment what is your latest Hba1C.

The HbA1C test is currently one of the best ways to check how well controlled your diabetes is.  It is the blood test that gets sent to the laboratory. Remember that it is not the same as blood glucose.

The HbA1C gives an average of your diabetes control over a 3 month period.
In the blood stream are the red blood cells, which are made of a molecule, haemoglobin. Glucose sticks to the haemoglobin to make a 'glycosylated haemoglobin' molecule, called haemoglobin A1C or HbA1C. The more glucose in the blood, the more haemoglobin A1C or HbA1C will be present in the blood. Red cells live for 8 -12 weeks before they are replaced.

Crucially, the HbA1C gives an average of your diabetes control over a 3 month period.

A normal non-diabetic HbA1C is 3.5-5.5%. In diabetes about 6.5% is excellent, and under 7% is good

Eye Screening

It is vital that you have your eyes checked every year.  You should be contacted directly by the diabetes eye screening unit once per year. This unit is a mobile unit and parks for a few days each spring at the medical centre car park.

The screening van visits us annually in the Spring.  You will be sent an invitation informing you when the mobile unit will be on site.  The Retina at the back of the eye can be damaged and if left unchecked can lead to needless loss of sight.  This test can detect early changes in retinal health so treatment can begin before sight is affected.

Urine Testing

Please bring along a urine sample to your appointment.  The urine sample needs to be the first of the day.

You will need to collect the urine in a "white top" plain urine container. These are obtainable at the medical centre. It is a good idea, however, for you to keep one or two of these at home so that you can always bring your sample in to the appointment. 

Please remember your sample.

The urine sample will test for albumin.  It is important because microalbuminuria is now accepted as an important marker, not only for early diabetic renal disease but also for vascular complications.

The annual review
This is an in depth opportunity to explore your diabetes control with a member of the diabetes nursing staff.

We are positive about emphasizing lifestyle factors. Weight control with healthy eating and exercise are the cornerstone to good diabetes control.
The review will include an opportunity to discuss your Hba1C, and an opportunity to discuss the results of your previous eye and urine tests. The review will also include an examination of your feet.

After your annual review, we will let you know whether you need a blood test before your next annual review. The hba1c may need to be repeated as often as every 3 months if you are having any changes to your medication.

Flu jab

We highly recommend that you have an annual flu jab.

Depression

Depression is commoner in patients with diabetes. Please bring along to your appointment a completed patient health questionnaire if you think that you could be depressed.

Diabetes Team – Who Does What?

Practice Nurse - Will discuss with you:
 

	Your general well being and how you are coping with your diabetes
	Current treatment/medication
	Diabetes control, including home monitoring and review of results
	Blood pressure control
	Cholesterol levels

It may well be that everything is controlled and you may not need to see the Practice Nurse.  In that case, your annual review will be completed by a Health Care Support Worker who has had specialist training in diabetes care.

Health Care Support Worker – will undertake the physical assessments

	Healthy eating + Exercise
	Height + weight for BMI
	Waist Measurement – This can provide useful indicators of insulin resistance
	Ladies less than 88cm Men less than 102cm
	Legs and Feet - To check skin. Circulation and nerve supply
	Blood pressure- Aim for blood pressure to be below 130/80
	Smoking advice
	Alcohol intake
	Update Retinal screening
	First Urine sample of morning for Microalbuminuria.

^ Top of page