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Diabetes (central resource page)

  

Central resource page for management and referral information for Diabetes mellitus and its complications


This page is still in development

 

Lifestyle and risk factors

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Pre-diabetes (non diabetic hyperglycaemia) HBA1c 42-47 mmol/l

NHS Diabetes Prevention Programme

See details of the NHS Diabetes Prevention Programme for personalised support for patients to reduce their risk of Type 2 diabetes including education on healthy eating and lifestyle, help to lose weight and physical exercise programmes. Provided in conjunction with partner ICS.

Follow link or search Diabetes Prevention Programme

See link right for Pre-diabetes patient information

After diagnosis of Diabetes :

DESMOND diabetes structured education programme

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Patient information & resources

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Diet & exercise resources

Diet & exercise downloads click below

Management advice

Area Prescribing Committee Treatment Algorithm

Follow link or click on link right for detailed treatment guidance

Community GPWSI Diabetes & Lipid Clinic

Referrals for problematic diabetic management including:

  • Suboptimal glycaemic control despite three oral hypoglycaemic agents
  • Initiation of newer therapies such as SGLT2 inhibitors, GLP1s
  • Consideration for conversion to injectable therapies
  • Difficult to manage lipid problems in diabetic patients
  • Patients with unstable glycaemic control

Follow link to Community Diabetes & Lipid GPWSI Clinic GP Gateway page

Community Consultant Led Diabetes Clinic

Location: City of Coventry Health Centre Tuesday afternoon and Wednesday morning

Accepts diabetes patients that don’t meet the ‘Super Six’ criteria* for the UHCW clinics(The existing community Dietetics and Diabetes Specialist Nurse Clinics continue. The existing UHCW diabetes clinics will run in the new ‘Super Six’* form)

All referrals should be made via the NHS e-Referral Service into either RSS or directly to the service.

Follow link for further information on Community Consultant Clinics and telephone advice

Community Consultant Led Diabetic Specialist Dietician Services

  • All referrals should be made via the NHS e-Referral Service into either RSS or directly to the service.

Complications

Diabetic Complications: Retinopathy

Annually for all diabetic patients over the age of 12 years

Follow link for GP Gateway retinopathy and contact information

Diabetic Complications: Podiatry & Foot Clinic

Follow link for more information about risk levels and referrals

Follow link for GP Gateway podiatry information

Follow link for Rugby diabetic podiatry pathway

Visual guidance for checking feet in diabetes

Summary

LOW RISK: Normal Sensation & Perfusion +/- Palpable Pulses

Primary care team: Examine feet to detect risk factors & classify risk, agree a management plan including foot care education with each person.

Arrange annual recall as part of ongoing care and refer to foot specialists as appropriate


HIGH & RAISED RISK: Neuropathy, Deformity, Callus, Corns, Nail Pathologies

Podiatry Foot Protection Team: Provide specialist assessment and regular review as appropriate.

Podiatry treatment for skin and nail care, including provision of protective insoles and their renewal.

Agree management plan including intensified foot care education (further details available on GP Gateway under Podiatry)


NEW ULCER (wound) swelling discolouration / ULCER (Non healing: 4 or more weeks), Infection, Necrosis / Gangrene, Charcot, Painful Neuropathy: 

Multidisciplinary WISDEM Diabetes Foot Team: Highly specialised management of complex diabetic foot & lower limb conditions, with access to advanced investigations & working closely with other hospital specialties- via CHOOSE AND BOOK RSS  or Contact on call Diabetes SPR Bleep 1698 via UHCW switchboard (024 7696 4000)

In severe cases where admission to A&E is being considered Refer to GP Assessment Unit


ISCHAEMIA: Critical Ischemia, Digital Ischemia, Rest Pain, Wet Necrosis

Vascular surgery team: The department at UHCW offers advanced vascular investigation and revascularisation procedures for patients with occlusive peripheral vasculature.

Referral form available on GP Gateway. Referral via RSS

In severe cases where admission to A&E is being considered  please ring UHCW switch board (024 76964000) and ask for the on-call vascular consultant– available 24/7


Diabetic Complications: Renal

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