Diabetes

What is Diabetes?

Diabetes occurs when the level of glucose (sugar) in the blood becomes too high. Normally, after we eat, various foods are broken down in the gut into sugars which are then absorbed into the body. The main sugar is called glucose. To remain healthy, your blood glucose level should not go too high or too low. A hormone called insulin helps to take glucose from the bloodstream into various cells of the body. This helps to keep the blood sugar normal.

Insulin is made by special cells in the pancreas. In Type 2 diabetes, the commonest form,  you either: do not make enough insulin for your body`s needs, and/or the cells in your body are not able to use the insulin properly. .) Type 2 diabetes usually first develops after the age of 40. It tends to run in families. It is more common in people who are overweight. It is also more common in African, Afro-Caribbean and Asian people.

 

What are the symptoms of Type 2 diabetes?

Symptoms tend to develop quite slowly, over weeks or months. They include: excess thirst, passing large amounts of urine, tiredness, weight loss, and feeling generally unwell.

 

Diabetes - External Links

 

What care you should receive from the practice - The Team

Advance Nurse Practitioner / Practice Nurse

The advanced nurse practitioner is the lead professional.

You can make routine diabetic checks with any of the nurses or doctors. They can advise you about the diabetes and diet, carry out the routine health checks required and adjust the medication if needed.

The practice nurses can also provide free glucometers for you to check your own blood sugars at home and self management plans to guide you re your diabetes.

 

GP

The GPs focus on the more difficult cases, where aspects of the diabetes could be improved and medication may need changing. 

 

Diabetic nurse specialist.

The specialist nurse comes twice a week, and we book poorly controlled patients to see him. He is able to give detailed advice and also to start insulin if required.

 

Dietician

The dietician also comes once a month. She provides detailed advice re the appropriate diet. We refer all new diabetic patients and poorly controlled diabetics to her.

 

Chiropody

We do an annual foot check at the surgery. If however you have foot health problems we can refer you to the chiropody at St Leonards Hospital.

If it is medically urgent, they have an emergency foot health clinic at St Leonard every morning at 09.00 - 09.30. Simply walk in; you do not need a letter or appointment.

 

Retinal Eye Screening

Patients will be referred annually for a retinal eye screening.

 

What care you should receive from the practice - Services

Group educational classes

Nurse Lalita has been running these for 2 years now. We invite a group of up to 10 patients to come in together for two 3 hour sessions. In that time Lalita explains diabetes, diet and exercise etc in much more depth than a normal consultation allows. It is also very interactive and patients are free to ask questions as they go along. The feedback has been extremely positive and indeed many patients have increased their understanding of diabetes and have been able to change their lifestyle as a result.

All newly diagnosed diabetic patients will be referred routinely for a group education session conducted at the Homerton Hospital. We are now implementing "Year of Care" which means we will aim to advise you of your blood results prior to your consultation with the clinicians.

 

Weight loss classes

Many diabetics are overweight and we can help with free weight loss sessions, either with the health trainer or with the dietician.

Contact the Practice to enroll on this programme

 

Exercise on prescription

Exercise is essential for diabetics. We can offer subsidised gym membership via the exercise on prescription scheme.

Contact the Practice to enroll on this programme

 

Smoking  Cessation

Contact the Practice to enroll on this programme

 

What Care you should receive from the practice - Management of your condition

The practice nurses take the lead for the management of chronic diseases such as diabetes. When you need to make an appointment for a health check, as described below, please make it with the nurse. They are able to adjust medication as appropriate. If they have any concerns or need advice they will refer you to the GP.

We will send you the blood and urine test forms in the post every April, although, you will have to collect the urine sample bottles from the surgery. If your blood tests are abnormal we may request that you repeat them.

We also plan to invite all diabetic patients for a health check with the nurse every January. If you also have high blood pressure, then your BP  will also need be checked again in July. The eye tests are organised at the Homerton Hospital and are done throughout the year. It is really important that you keep your eye check appointments.

 

Recommended Tests for Diabetic Patients

Examination

  • Smoking status, and all patients who smoke to be advised to stop.
  • Weight and BMI checked
  • Foot check including an assessment of foot pulses and sensation
  • Eye test by approved tester, currently the Homerton hospital.
    Blood pressure, aiming for a level of 145/85 or less
 

Blood tests

  • HBA1c to assess diabetic control. Aiming for a level of 7.4 or less.
  • Cholesterol level, aiming for a level of 5 or less.
  • Serum creatinine as a measure of kidney function
 

Urine Tests

  • Microalbumin ratio as a measure of  kidney function
 

Vaccination

  • All patients should have the flu jab in autumn

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