Reviewed on : 1 Jul 2024

Reviewed by : GP Gateway Editor

Expires : 1 Jul 2026

Please note this page is still in development and content may change frequently

Lifestyle and risk factors

Awaiting contribution

Pre-diabetes (Non diabetic hyperglycaemia 42-48mmol/l)

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 WW.

Follow link or search Diabetes Prevention Programme

See link right for Pre-diabetes patient information

After diagnosis of Diabetes :

Type 2 DESMOND diabetes structured education programme

Coventry and Rugby Desmond is now delivered by the GP Alliance

Follow this link to the GP Gateway DESMOND page

Patients can self-refer via email or telephone:

• Telephone: 0808 169 1225
• Email: crgpa.desmondreferrals@nhs.net

Attached is a leaflet which GP’s can print off to hand to patients with Desmond contact and information

Patient information & resources

Case studies:

Michelle’s story: ‘Michelle shares her journey on becoming healthier, significant weight loss and reversing her diabetes diagnosis with ‘Teddy’s Target’.

https://www.youtube.com/watch?v=L_7Z8gWI46I

‘Fixing Dad’: Fixing Dad is about an ordinary British family’s battle with type 2 diabetes… and how their remarkable success offers hope to millions.

Three years ago, Geoff was overweight, overworked and resigned to a premature death from complications associated with being diabetic. His doctor had begun talking about the possibility of foot amputation.

https://www.youtube.com/watch?v=eEroeCTJd9Y

Pocket Medic Patient Guides: Coventry & Rugby Resources:

Pre Diabetes Pocket Medic CRCCG

Gestational Diabetes Pocket Medic CRCCG

Black Asian Minority Ethnic Pocket Medic CRCCG

Type 2 Part 1 Pocket Medic CRCCG

Type 1 Part 1 Pocket Medic CRCCG

Type 1 Part 2 Pocket Medic CRCCG

Diet & exercise resources

Diet & exercise downloads click below

• Diabetes: How to take control (UHCW resource regarding diet and exercise)
• Eating well with diabetes
• Eating well with diabetes (Polish version)

Type 2 Diabetes Treatment Algorithm (Area Prescribing Committee)

See link in documents RIGHT for full document with working links

Type 2 Diabetes Blood Glucose Monitoring

• Guidance Click link
• Blood Glucose Testing Strips Formulary September 2023

Prescribing needles lancets and sharps boxes

Click link

Type 1 Diabetes

Step by Step Education

Newly diagnosed patients (within a year of diagnosis) will be invited to attend Step by Step.

Carbs 4 1 Education

Type 1 Diabetes Education – CARBS 4-1

The course is suitable for:

• Adults with Type 1 Diabetes on a basal bolus insulin regime who want to self-manage their diabetes and learn how to carbohydrate count.
• Participants must understand and speak English
• Those with learning difficulties and mental health issues will need to be assessed by the team prior to the course
• It is NOT suitable for Type 2 diabetes, BD regimes, people under 18 years old

Aims of the course:

The structured course aims to improve self-management skills, resulting in lower HbA1c and reduced hospital admissions with severe hypo or DKA.

What it involves:

• Groups of up to 15 participants attend four full day sessions a week apart, in either Coventry or Rugby
• Patients are given a choice of venue and date, but they need to attend all four sessions
• Patients must be motivated to change behaviour and take control of their diabetes
• This course is mandatory for anyone who wants to be considered for an insulin pump

Course content:

• How insulin works
• Learning how to count carbohydrates and apply a ratio to bolus insulin
• Correct management of hypoglycaemia
• Coping with illness and avoiding DKA
• Exercise management
• Managing alcohol, snacks and eating out
• Travelling with diabetes
• Glycaemic index
• Diabetic complications and how to prevent them
• Psychological approaches to living with diabetes

Benefits:

• Improved HbA1c
• Fewer severe hypos
• Confidence in self-management
• Improved quality of life
• Reduced insulin requirements

Venues:

• The Atrium Health Centre, Watch Close, Coventry CV1 3LN
• The Hospital of St Cross Diabetes Centre, Barby Road, Rugby CV22 5PX

If you wish to refer a patient or have any queries relating to the courses please telephone 01788 572831 or email carbs41stx@uhcw.nhs.uk

Please complete CARBS 4-1 Referral Form – see right

Type 1 referral form – see right

FreeStyle Libre Prescribing

Further information on Flash Testing (Freestyle Libre) follow link

Management advice

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

Community Consultant Led Diabetic Specialist Dietician Services

Diabetic Complications: Retinopathy

Retinopathy screening 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 or click on image below for larger version

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

Awaiting contribution