Being diagnosed with diabetes can be bewildering and distressing. There is often a great deal of information to take in and it can mean starting one or more new tablets. At the time of diagnosis people often have preconceived ideas about the effects that diabetes can have on their welfare.
Whether you have recently been diagnosed, or have lived with diabetes for some time, we are here to help you adapt to living with diabetes, and minimise any impact that it might have on your life.
Newly Diagnosed Diabetics
Patients who have recently been diagnosed with diabetes will need to see the doctor and practice nurse a few times in the first few months. During this time patients and carers will be given support, information and advice about managing diabetes. This will involve some blood tests being done at the surgery but these will be kept to a minimum. It is not usually necessary for patients to check their own blood sugar right away unless they particularly wish to do so.
Patients will be given the opportunity to see a dietician for initial dietary advice, since this is the single most important part of achieving good control of diabetes. The practice nurse can give additional dietary advice.
It is also important that all newly diagnosed patients are seen for a diabetic eye check. This is a more thorough and detailed examination than is usually done when being assessed for glasses,and involves having a photograph taken of the back of the eye. The doctor or Practice Nurse canarrange for this to be done.
It is also worth considering joining Diabetes UK, an excellent charity which will send out some very useful information about managing and living with diabetes, as well as advertising local events (www.diabetes.org.uk).
How Often Will You Need To Be Seen?
We aim to review all patients with diabetes on a regular basis – at least once every year or more frequently if some aspect of control needs closer attention.
If you have only been diagnosed recently, either the doctor or the nurse will see you every few weeks, until both you and the doctor or nurse are happy with the level of control.
Who Is Involved With Care?
Diabetes can affect many organs in the body, and good care therefore needs a team approach, involving a number of health professionals. This can seem a bit daunting to start with, but with proper organisation the inconvenience and aggravation can be minimised. However, first and foremost, the patient must be involved in their own care, and health professionals are there to help and support the patient in their own management.
Some of the complications of diabetes may not cause any symptoms to the patient initially. It is only by having regular checks that these complications can be detected early, and appropriate treatment given before they start to adversely affect ones health. The following health professionals are the main ones involved in regular care to look for early signs of any complications, and offer advice about appropriate management.
- Podiatrist – to check the state of your feet.
- Dietician – to help gain optimal control by helping you adapt your eating habits.
- Practice nurse – to offer advice on any aspect of your care.
- District nurse – to help those patients who are unable to come to the surgery.
- Smoking advisor – to assist with stopping smoking.
- GP – to help interpret your blood test results, and give advice about your medication.
The majority of patients are looked after within general practice only, and do not need to be referred to the hospital. However, patients with more specific or difficult problems may be referred to the hospital consultant or diabetic liaison nurses.
Yearly diabetic clinics provide an opportunity for the appropriate team members to come together thereby minimising the inconvenience to patients of having to visit different people in different places at different times. However, it does mean that it takes about an hour and a half for patients to see all the necessary people. The clinic usually takes place in the morning of the 3rd Tuesday in the month. If you would like somebody to accompany you to the clinic, we are quite happy for him or her to sit in on your consultations.
You will be invited to the clinic by letter at about the same time of year each year. If the appointment you are offered is inconvenient, you can phone and ask for it to be changed. You will be asked to see the practice nurse a couple of weeks before the clinic date, to have blood taken (you do not need to starve overnight before the blood test). It is helpful if you bring a sample of urine from the first time you pass water that day, when you come to that appointment. This ensures that all the results should be available on the day of the clinic.
On the day of the clinic you will be seen by the practice nurse, the chiropodist, the dietician and the doctor, having about 20 minutes with each.
Although the clinic is an opportunity to ensure that all the necessary blood tests etc. have been done, it is also an opportunity for patients to raise any concerns or problems that they might have. If there is anything that you wish to ask or that you are not sure about, you must feel free to talk to any of the healthcare staff that you see in the clinic. They will all be happy to try to answer any questions.
If a patient is housebound, and therefore unable to attend the diabetic clinic, alternative provision can be made for home visits.
In addition to the annual diabetic clinic, patients should be seen by the eye screening service each year for a diabetic eye check. This will not be done at the time of the clinic appointment in the surgery. A reminder should be sent to your home address when an annual review is due. This service is now a mobile screening service.
All the doctors and practice nurses are also happy to see people in surgery time to address any aspect of their diabetes that may be causing concern.
Other Things to Remember
If you take tablets or insulin to help control your blood sugar, you are entitled to a prescription exemption certificate, which enables you to get all your prescriptions for free (not just those that relate to your diabetes).
You must notify DVLA if you are started on tablets for diabetes control, or insulin. This does not mean that you will have your licence taken away, but they do need to know about your condition. HGV and PSV drivers should ask the doctor or nurse when to notify DVLA.