It is essential that your diabetes is reviewed yearly by your diabetes team. Appointments should be sent to you from your diabetes team, it is important that you do attend the clinics. This is to ensure that your treatment is correct and your target diabetes levels are being obtained between 4 - 7 mmol/l and to prevent the onset of diabetes complications.
Expect your diabetes to be reviewed yearly. It is important that your nurse or doctor reviews your diabetes and its treatment on a regular basis.
There are many ways that your doctor can check whether you are developing Diabetic Complications with your: Feet, Eyes, Heart, Kidneys, Circulation, and Nervous System. Therefore it is important that you have your yearly MOT / Annual Review.
It is essential that you attend your annual review appointment so that we can catch any potential problems early on hence It is very important that you attend. The following will be checked
The diabetes team will take a blood sample from your arm. During the life of a red blood cell (8-12 weeks) sugar sticks to part of it. This blood test gives an overview of the level of your blood sugars over the last 2-3 months. This will inform your diabetes team as to the level of your diabetes control.
HbA1c Target Level To show good diabetes control the HbA1c result should be between 6.5-7.5% where 7% is the ideal target.
Ways to reduce your HbA1c Always ask your diabetes team what your HbA1c result was, and by comparing it with previous results you will be able to monitor your progress. If your HbA1c is too high, your current diabetes treatment may need changing.
Download the new Haemoglobin A1c Testing (HbA1c) information leaflet produced by the Department of Diabetes and Endocrinology and the Department of Ophthalmology Department
Cholesterol is fat that circulates around the body in your blood. There two main types of blood fats these are:
Cholesterol Target Level: to reduce you risk of getting a heart attack the total cholesterol level should be below 5mmol/l Recent research has shown that a level nearer 3.5mmol/l may be better.
Having too much fat (bad cholesterol) in the blood can contribute towards developing heart diseases and stroke.
Ways To Reduce Your Lipid Levels:
Reduce weight and saturated (animal) fat intake; take regular physical activity; eat more fruit and vegetables, eat oily fish twice a week, limit alcohol intake, control glucose levels.
Blood pressure is the amount of outward pressure that your blood puts on the walls of your blood vessels. Thus a blood pressure check is the measurement of the pressure at which your heart pumps blood through you arteries.
There are two numbers, a systolic and diastolic: the systolic is the amount of pressure when your heart pumps the blood and is the higher value.
The diastolic is the amount of pressure when your heart is recovering before it pumps again, this is the lower value.
Target blood pressure the target is 140/80 mmHg or below.
If you have kidney problems then the target is 130/70mmHg
High blood pressure is an important contributor to conditions such as heart disease, stroke and kidney disease.
Ways to reduce your blood pressure : loose excess weight and keep it off, reduce salt intake and stress levels, stick to recommended alcohol intake, increase regular physical activity, stop smoking.
They may also take a waist circumference measurement to predict your risk.Carrying too much weight around your middle increases your risk of heart disease, affect BP and cholesterol and can make you insulin resistant. Your diabetes team will weigh and measure your height and check your Body Mass Index (BMI) to find out your health risk.
If you are overweight, a 5-10% weight loss can reduce the risk of heart disease and stroke. E.g. if you weight 100 kg aims to lose 10kg. On the other hand being underweight is not healthy and can be due to poor diabetes control. Discuss this with your diabetes nurse/team. If needed you can request to be referred to dietician.
The Diabetic Eye Screening Service for Leicestershire and Rutland
This is a mobile screening unit that makes appointments with GP surgeries to attend yearly to perform retinal screening for the diabetes patients with in the surgery. You will be notified by your GP if you are needed to attend the mobile eye screening unit. (This will be at the GP surgery).
You will then see the diabetic retinal screener who will ask you some questions about your diabetes. They will then check your vision using an eye chart, and put drops into your eyes to dilate the pupils. These drops take 20 minutes to work and will slightly blur the vision for a few hours before returning to normal. Once your pupils have dilated your eyes will be photographed. a special camera is used with a flash, but it does not touch or hurt your eyes. It will take about 45 minutes.
It is important that you attend your appointment. If you cannot attend you must inform your GP practice so alternative arrangements can be made. You may not need to come if you attend a hospital eye clinic.
Remember to take any glasses that you have to every eye appointment.
Remember however if your vision is getting worse, this does not necessarily mean you have diabetic retinopathy. It may simply be a problem that can be corrected with glasses.
The photographs will be reviewed by trained retinal screener, under the supervision of an eye specialist. Both you and your GP will be notified of the results by post 1 month later.
If significant changes are found or the photographs are difficult to interpret, you will be asked to attend an eye outpatient clinic at the Leicester Royal Infirmary.
If you notice changes with your eyesight, you should contact your optician or eye clinic.
Although your vision may be good, changes can be taking place in your retina that needs treatment, because most sight loss due to diabetes is preventable.
The sooner changes or problems are spotted, the more likely it is that they can be treated and prevented from getting worse. Your feet will be examined by your doctor, nurse or podiatrist (foot specialist)
They will check for pulses, cuts, bruises, marks and blisters. A sensory nerve examination can be carried out by your diabetes team.
In addition you should keep a close eye on yourself by checking your feet daily. If you notice anything unusual, such as unusual cuts, marks, discolouration or blisters on your feet, see your GP as soon as possible. If you think anything is wrong contact your clinic straight away. Download the Putting Feet First: Your Annual Foot Review
The diabetes team will either check your urine to see if your kidneys are performing well, this will include protein presence.