G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 1

Size: px
Start display at page:

Download "G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 1"

Transcription

1 G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 1

2 BHCiG: TYPE 2 DIABETES MANAGEMENT PATHWAY MODEL INTRODUCTION What is the aim of the model? To improve the capacity of primary care health practitioners to better respond to the needs of people living with type 2 diabetes. What does the model describe? The model describes a continuum of care pathway from risk screening through to recall & review and ongoing risk assessment. Within the model clients would be screened/ assessed to determine need, priority of access & appropriate management pathways. It sets out a pathway which integrates risk prioritization at different steps along the way within the Annual Cycle of Care used by GP s. It will be supported by common Gippsland referral processes and feedback tools. What is the scope of the model? While the whole process from risk screening to ongoing assessment is described the BHCiG project is primarily concerned with the process from initial assessment onwards. This means that within the annual cycle of care if diabetes complications become present or increase then the response would become more intense until the risk was stabilised and patient would return to regular annual cycle of care visits. Who does it involve? The pathway reads with the GP as the central person the gateway who initiates the referrals. While this is true of a newly diagnosed client especially during initial assessment and diagnosis this may not be the case for someone already in the system especially when it comes to a change in the person s level of risk complications. Referral pathways will include other health professionals as they interact with the client with diabetes. How will it be tested? The BHCiG Chronic Disease Management Task Group has endorsed the final model. It will be the role of the local networks to establish how they implement it within agreed standards. The model is presented with best practice standards that underpin the model. However the local protocols, processes, procedures and systems that describe how these standards will be implemented will be developed at a local level where the model will be tested. These standard practices and processes would apply to each stage or component of the model. The first two stages of the model already have standards of practice used by GPs (NHMRC). G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 2

3 GLOSSARY Type 2 Diabetes: Previously known as non insulin dependent diabetes mellitus (NIDDM ) or mature onset diabetes BHCiG: Better Health Care in Gippsland is the name of the overall service coordination and chronic disease project jointly funded by the Commonwealth and State governments NHMRC: National Health and Medical Research Council DE: Diabetes Educator RACGP: Royal Australian College of General Practitioners WHO: World Health Organisation GP: General Practitioner DHS: Department of Human Services CVD: Cardio-vascular Disease ATSI: Aboriginal and Torres Strait Islander CALD: Culturally and Linguistic Diverse population. Previously the term Non English Speaking Background BMI: Body Mass Index HbA1c: Glycated Haemoglobin K10 tool: Kessler-10 is a self rating questionnaire which is used to measure psychosocial distress EPC Care Plan: for the purposes of this project it refers to a plan of action aimed at meeting the care needs of a high risk client with type 2 diabetes. It sets out the services to be provided by the clients GP and at least 2 other health or community care providers involved in their care. A date to review the care plan is also set at this time SC care plan: Multi-agency Service Coordination plan template designed by DHS to support shared care planning. Can be used as an alternative to EPC care plan EPC: Enhanced Primary Care Program BP: Blood Pressure BSL: Blood Sugar Levels RBSL: Random Blood Sugar Levels Case conference: A case conference is a meeting held between a client s GP and at least two other health or community care providers to jointly agree on the types of services the client needs. The meeting can be by phone, face to face or through video conferencing. It differs from a care plan in that it usually involves immediate management plans. However holding the case conference may identify the need for developing a care plan and visa versa. Care Coordinator: A nominated worker who has the responsibility of ensuring that the care plan is implemented, and that reviews and re-assessments are undertaken at the appropriate times by the relevant service providers Activities may include some or all of: Assessment Care plan development Referral and/or feedback Implementation of the care plan, including liaison with service providers Monitoring Review Reassessment Management of brokerage funds. G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 3

4 BHCiG: TYPE 2 DIABETES MANAGEMENT PATHWAY MODEL - SUMMARY PLEASE NOTE THIS IS A SUMMARY OF THE MODEL ONLY. YOU WILL NEED TO REFER TO THE MORE DETAILED DESRIPTION OF EACH STAGE OF THE MODEL AS DESCRIBED IN THE FOLLOWING PAGES STAGE COMPONENTS INITIAL SCREENING DIAGONSIS Risk screening of non diagnosed Type 2 Diabetes clients to identify those at high risk Clients identified as being at high risk of Type 2 Diabetes referred to and then by GP for diagnostic testing of blood glucose levels (measurement of venous plasma glucose) Follow up GP appointment made at time of GP ordering plasma glucose test Laboratory test undertaken(measurement of venous plasma glucose) Diagnosis of diabetes made according to Type 2 diabetes guidelines case detection and diagnosis information [ WHO guidelines, NHMRC INITIAL ASSESSMENT & ON-GOING REVIEW GP conducts initial detailed specialist assessment of patient, physical examination and orders further investigations [Diabetes Management in general practice 2004/5 Diabetes Australia & RACGP] GP develops with patient immediate care to relieve acute symptoms ONGOING REVIEW and ASSESSMENT of CARE REFERRALS AND IDENTIFICATION OF DIABETES TEAM CARE PLAN DEVELOPED RECALL & REVIEW and RISK COMPLICATIONS Based on assessment GP instigates referrals to appropriate health professionals using agreed referral cover sheet & Victorian Statewide Referral Form (once electronic) with priority access rating according to BHCiG Type 2 Diabetes risk map Referral feedback on assessment outcomes (via BHCiG Diabetes Management feedback forms) received by GP within maximum 6 weeks unless assessed as high risk Care Coordinator appointed for high risk clients Diabetes Management plan developed with client (and carer) and other nominated health professionals in diabetes care team (with case conference or other process as agreed) Cycle of care process established for all diabetes clients with agreed responsibilities of members of diabetes team and with agreed timelines & feedback processes Diabetes management plan documented in patient kept record [Diabetes Health Record] and client record Diabetes team members document visit outcomes in patient kept record and client medical record Diabetes team members continue to refer to appropriate health professionals where risk status has altered Ongoing risk assessment of diabetes complications of client by GP or other agreed health professional (ie: DE, practice nurse) using BHCiG Type 2 Diabetes risk map G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 4

5 STEP 1: SCREENING UN-DIAGNOSED DIABETES IDENTIFIED VIA A NUMBER OF POSSIBLE PATHWAY OPTIONS using DHS Community Based Risk Assessment Guide for CVD and Diabetes (see box below) GP CLIENT REGISTER SELF REFERRAL COMMUNITY BASED SCREENING OPPORTUNISTIC SCREENING OF HOSPITAL PATIENTS RISK SCREENING If client has one or more of these risk factors present then refer to GP Persons aged > 50 years Impaired glucose tolerance or impaired fasting glucose Women with history of gestational diabetes ATSI persons aged 35+ CALD background specifically people of pacific islander, indian subcontinent and of chinese origins People aged 45+ with one or more of the following: Obesity (BMI > 30mg/m 2 ) 1 st degree relative with diabetes hypertension All people with clinical CVD Women with polycystic ovarian syndrome who are obese Source: DHS Community Based Risk Assessment Guide for CVD and Diabetes IS THIS PERSON AT RISK OF DEVELOPING DIABETES? NO Provide advice on exercise and diet and early symptoms of diabetes Who: Provided by either GP, practice nurse, diabetes educator, community health nurse Resources: Provide client with local physical activity guide or consider using active script (GP) YES REFERRAL TO GP for PLASMA GLUCOSE TEST (see step 2) G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 5

6 STEP 2: DIAGNOSIS GP ORDERS PLASMA GLUCOSE FOR MORE DETAIL REFER TO: DIABETES MANAGEMENT in GENERAL PRACTICE 2004/5 GUIDELINES (RACGP DIABETES AUSTRALIA) < 5.5 Fasting: Random: Fasting :> 7.0 Random: >11.1 Diabetes unlikely Place on register and recall every 2 years Provide education & information on diet & exercise, CVD and diabetes risk; referral to lifestyle program as appropriate Diabetes unlikely Diabetes uncertain Oral glucose tolerance test 2 hour glucose levels < >11.1 Impaired glucose tolerance Diabetes likely Fasting blood glucose test annually Place on register and recall every 12 months Provide education & information on diet & exercise, CVD & diabetes risk; referral to lifestyle program as appropriate Diabetes likely Appointment with GP to begin comprehensive assessment and develop care plan (see step 3A) G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 6

7 STEP 3A: ASSESSMENT & ONGOING REVIEW DIAGNOSIS CONFIRMED and ASSESSMENT begins FOR MORE DETAIL REFER TO: DIABETES MANAGEMENT in GENERAL PRACTICE 2004/5 GUIDELINES pp7-8 (RACGP DIABETES AUSTRALIA) HISTORY: Specific symptoms: predisposition to diabetes, risk factors for complications, general symptoms review, lifestyle issues EXAMINATION: Weight and height measured, BMI, waist circumference, BP, CV system, eyes, feet, peripheral nerves, urinalysis INVESTIGATION: Establish baseline [renal, lipids, glycemia] PLUS consider others if one of the following: - ECG if >50years - Microurine if high risk group [women with neuropathy, vaginal pessary] - Thyroid function if family history or clinical suspicion BASED on this ASSESSMENT the GP can then make an initial determination of the clients risk of DIABETES COMPLICATIONS (see Step 3B) and begin a more comprehensive assessment process with initial referrals (see step 4) G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 7

8 STEP 3B: LEVEL OF DIABETES RISK ESTABLISHED USING RISK MAP The GP by using the risk map to refer to other practitioners can confidently ensure that their client is seen expediently according to the agreed risk rating. This priority of access can change at any time during the person s cycle of care if level of complications alters. URGENT RISK defined as patient with any of the following: Glycaemic Control: RBSL > 23 Uncontrolled hyper or hypo glycemia Foot: Ulcer with cellulitis requiring bed rest & IV antibiotics Ischaemic leg/foot with rest pain Gangrene Diabetic client with an urgent co-morbid condition Eye: sudden loss of vision RESPONSE: Immediate hospital admission and/or referral to specialist as part of continuum of care HIGH RISK defined as patient with any of the following Glycaemic Control: RBSL 15>23; HbA1c >9.0 Commencement of insulin therapy Self Management: Poor self management capacity Carer illness resulting in need for respite care Foot: Ulcer with cellulitis requiring IV antibiotics (but capacity for district nurses to monitor) Renal: Clinical proteinuria (macrobuminuria) dipstick reading > 500 mg/l Eye: visual impairment Hypertension: hypertension, particularly if proteinuria > 1g/d REFERRAL RESPONSE: GP contacts health practitioner (s) via phone, identifying patient as high priority for an appointment. Patient is given the referral letter along with the referral cover sheet to take to the appointment. Referral outcome received by GP within 1 week of contacting health practitioner. MEDIUM RISK defined as patient with any of the following Glycaemic Control: RBSL 12>15; HbA1c Dyslipidaemia: cholesterol > 6.5 mmol/l; triglyceride > 4.0 mmol/l (National Heart Foundation high risk group because of diabetes) Foot: Peripheral neuropathy REFERRAL RESPONSE: GP gives referral letter and referral cover sheet to patient and marks the referral as medium priority. GP instructs patient to identify the referral as being medium priority. Referral acknowledgement sent to GP by health practitioner within 5 working days of receipt. Referral outcome received by GP within 2 weeks of GP instigating referral. Patient rebooked to see GP 2 weeks from initial appointment. LOW RISK as defined as patient with any of the following Glycaemic Control: RBSL <12; HbA1c < 7.0 Microalbuminuria ( µg/min) Eye: Refractive errors blurred vision; cataracts; retinopathy Foot: Potential abnormal foot architecture Peripheral vascular disease: claudication REFERRAL RESPONSE: GP gives referral letter and referral cover sheet to patient and marks the referral as low priority. GP instructs patient to identify the referral as being low priority. Referral acknowledgement sent to GP by health practitioner within 5 working days of receipt. Referral outcome received by GP within 6 weeks of GP instigating referral. Patient rebooked to see GP 6 weeks from initial appointment. SOURCE: Based on DIABETES MANAGEMENT in GENERAL PRACTICE 2004/5 GUIDELINES G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 8

9 STEP 4: REFERRALS AND IDENTIFCATION OF DIABETES TEAM ACTIVITY TYPES IN RED FONT ARE MINIMUM initial REFERRALS. Commence COMPREHENSIVE ASSESSMENT FOR ALL NEWLY DIAGNOSED CLIENTS. Please see next page Referral sent within 1-7 days of diagnosis. Response as per risk level EYE CARE DIET EXERCISE SELF MANAGEMENT EDUCATION FOOT CARE Referral to ophthalmologist or suitably trained optometrist Diagnosed with eye disease? YES NO Review 12mthly Provide educatio n & info Referral to dietitian for all clients Review yearly or more often as per agreed workplan (ALL clients) Provide assessment, advice & individual plan Review every 2 years Provide education and information about early symptoms of eye disease Referral to DE Provide assessment, advice & individual plan (ALL clients) Consider assisted referral to community based exercise activities Referral to DE Review yearly or more often as agreed by DE client and according to risk rating Assess for self management capacity Develop individual plan (including individual & group activities) Consider referral for medium and high risk clients to self management programs REFERRAL FEEDBACK TO GP Referral to DE or GP for Assessment Assessed as high risk using CWGPCP tool Refer to podiatrist Assessed as low risk using CWGPCP tool Response Annual comprehensiv e assessment Assess/ recommendati on for appropriate foot wear Provide education for preventive self care Complete action plan G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 9

10 STEP 4: INITIAL REFERRALS AND IDENTIFCATION OF DIABETES TEAM (continued from previous page) Commence COMPREHENSIVE ASSESSMENT FOR ALL NEWLY DIAGNOSED CLIENTS GLYCAEMIC CONTROL MENTAL HEALTH ACTIVITIES IN BLUE FONT REFERRALS ONLY IF PROBLEMS PRESENTING AT TIME OF INITIAL ASSESSMENT Is this person experiencing uncontrolled hyper or hypoglycaemia OR experiencing significant level of complications? Is this person presenting with a mental health problem? YES NO YES Refer to Physician Response Assessment & clinical plan Refer to DE As per self management response Assessment for anxiety & depression using K10 tool Consider referral to primary mental health worker or appropriate mental health professional Liaise with clients case manager (if applicable) Referral to DE for self management support Continue to monitor REFERRAL FEEDBACK TO GP G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 10

11 STEP 5: MULTI-DISCIPLINARY CARE PLAN DEVELOPED & CARE COORDINATOR DETERMINED SHOULD THIS CLIENT HAVE A CARE COORDINATOR? YES if HIGH RISK (multi-agency involvement or complex needs) defined as patient with any of the following Glycaemic Control: RBSL 15>23; HbA1c >9.0 Commencement of insulin therapy Self Management: Poor self management capacity Carer illness resulting in need for respite care Foot: Ulcer with cellulitis requiring IV antibiotics (but capacity for district nurses to monitor) Renal: Clinical proteinuria (microalbuminuria) dipstick reading positive > 500 mg/l Eye: visual impairment Hypertension: hypertension, particularly if proteinuria > 1g/d Care coordinator identified Care coordinator initiates case conference if immediate management care needed Care coordinator develops care plan (EPC item) with relevant HP, client (and carer) Documented in Diabetes Patient Record Review date set NO if MEDIUM RISK defined as patient with any of the following Glycaemic Control: HbA1c ; RBSL 12>15 Dyslipidaemia: cholesterol > 6.5 mmol/l; triglyceride > 4.0 mmol/l (National Heart Foundation high risk group because of diabetes) Foot: Peripheral neuropathy Implement cycle of care with additional visits per referral feedback reports Documented in Diabetes Patient Record Send copy of care plan to all relevant HP professionals Implement recall & review process as agreed to by diabetes team NO if LOW RISK defined as patient with any of the following Glycaemic Control: HbA1c < 7.0; RBSL <12 Microalbuminuria ( µg/min) Eye: Refractive errors blurred vision; cataracts; retinopathy Foot: Potential abnormal foot architecture Peripheral vascular disease: claudication Implement annual cycle of care Document in client record and Diabetes Patient record G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 11

12 STEP 6: RECALL AND REVIEW PLUS IDENTFICATION OF DIABETES COMPLICATIONS Implement Annual Cycle of Care for newly diagnosed Type 2 diabetes first year Add additional visits based on referral outcomes from initial assessment OR if level of risk changes CYCLE OF CARE WHAT CLIENT TYPE High risk = HR; Medium risk = MR; Low risk = LR 3 MONTHS 6 MONTHS 12 MONTHS BP, BMI, weight, review symptoms, review self monitoring Check urine, check BSL record Y Y Y Y HbA1c, urine analysis Y Y Y lipids Y Y Y Foot examination, Y BP, BMI, review symptoms, review self monitoring, BP, lifestyle behaviour, foot review, waist circumference, Full assessment BP, lifestyle behaviour, review symptoms,, review lipids foot review, BMI, waist circumference, review self Y monitoring Eye exam Y Y 24 MONTHS Eye exam (if no eye damage diagnosed at initial assessment) Y Y Y Y Y Y Y Y Y HEALTH PROFESSIONAL To be determined by local networks Continue to document in PHR and client record; consider additional referrals; transfer information as agreed G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 12

13 RESOURCES TO SUPPORT REFERRALS HEALTH DOMAIN RESOURCES EYE CARE BHCiG eye exam summary assessment report DIET BHCiG dietitian summary assessment report EXERCISE Local recreation and sport directory SELF MANAGEMENT EDUCATION Diabetes health record patient held record BHCiG Diabetes Educator summary assessment report FOOT CARE BHCiG foot exam summary assessment report Best feet forward resource kit GLYCAEMIC CONTROL Diabetes Management in General Practice in General Practice 2004/2005 (RACGP Diabetes Australia) MENTAL HEALTH Anxiety & depression screening tool (K10) Community support groups OTHER RESOURCES CARE PLANNING EPC care plan tool EPC Standards and Guidelines MEDICARE Plus CASE CONFERENCING EPC case conference item GENERAL Diabetes Management in General Practice in General Practice 2004/2005 (RACGP Diabetes Australia) BHCiG Diabetes Resource Directory Victorian Statewide referral form G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 13

Diabetes Management in the Primary Care Setting

Diabetes Management in the Primary Care Setting APNA Online Learning www.apna.asn.au/onlinelearning Diabetes Management in the Primary Care Setting Course Summary Diabetes Management in the Primary Care Setting is an online learning program aimed at

More information

Markham Stouffville Hospital

Markham Stouffville Hospital Markham Stouffville Hospital Adult Diabetes Education Frequently Asked Questions What is diabetes? Diabetes is a disease in which blood glucose levels are above normal. Most of the food we eat is turned

More information

Institute of Applied Health Sciences. University of Aberdeen DATABASE REVIEW. Grampian University. Hospitals NHS Trust GRAMPIAN DIABETES

Institute of Applied Health Sciences. University of Aberdeen DATABASE REVIEW. Grampian University. Hospitals NHS Trust GRAMPIAN DIABETES DATABASE REVIEW Grampian University Hospitals NHS Trust GRAMPIAN DIABETES SERVICES DATABASE Page 1 Contents Contents 2 Introduction 3 History 3 Overview of Database 3 Database Structure 4 Main Table Summary

More information

Diabetes. C:\Documents and Settings\wiscs\Local Settings\Temp\Diabetes May02revised.doc Page 1 of 12

Diabetes. C:\Documents and Settings\wiscs\Local Settings\Temp\Diabetes May02revised.doc Page 1 of 12 Diabetes Introduction The attached paper is adapted from the initial background paper on Diabetes presented to the Capital and Coast District Health Board Community and Public Health Advisory Committee

More information

what is diabetes? What actually goes wrong? Talking diabetes No.42

what is diabetes? What actually goes wrong? Talking diabetes No.42 Talking diabetes No.42 what is diabetes? Diabetes is the name given to a group of different conditions in which there is too much glucose in the blood. The pancreas either cannot make insulin or the insulin

More information

Diabetes: Factsheet. Tower Hamlets Joint Strategic Needs Assessment 2010-2011. Executive Summary. Recommendations

Diabetes: Factsheet. Tower Hamlets Joint Strategic Needs Assessment 2010-2011. Executive Summary. Recommendations Diabetes: Factsheet Tower Hamlets Joint Strategic Needs Assessment 2010-2011 Executive Summary Diabetes is a long term condition that affects 11,859 people in Tower Hamlets, as a result of high levels

More information

Diabetes Brief. Pre diabetes occurs when glucose levels are elevated in the blood, but are not as high as someone who has diabetes.

Diabetes Brief. Pre diabetes occurs when glucose levels are elevated in the blood, but are not as high as someone who has diabetes. Diabetes Brief What is Diabetes? Diabetes mellitus is a disease of abnormal carbohydrate metabolism in which the level of blood glucose, or blood sugar, is above normal. The disease occurs when the body

More information

HLTEN611B Apply principles of diabetic nursing care

HLTEN611B Apply principles of diabetic nursing care HLTEN611B Apply principles of diabetic nursing care Release: 1 HLTEN611B Apply principles of diabetic nursing care Modification History Not Applicable Unit Descriptor Descriptor This competency unit describes

More information

Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both.

Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. Diabetes Definition Diabetes is a chronic (lifelong) disease marked by high levels of sugar in the blood. Causes Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused

More information

Measuring and Improving the Quality of Diabetes care in General Practice. Dr M Grixti. Dr C Scalpello, Dr C Mercieca, Dr P Mangion, Dr T O Sullivan

Measuring and Improving the Quality of Diabetes care in General Practice. Dr M Grixti. Dr C Scalpello, Dr C Mercieca, Dr P Mangion, Dr T O Sullivan Measuring and Improving the Quality of Diabetes care in General Practice Dr M Grixti. Dr C Scalpello, Dr C Mercieca, Dr P Mangion, Dr T O Sullivan Outline of presentation Statistics Diabetes care,as the

More information

Diabetic nephropathy is detected clinically by the presence of persistent microalbuminuria or proteinuria.

Diabetic nephropathy is detected clinically by the presence of persistent microalbuminuria or proteinuria. Kidney Complications Diabetic Nephropathy Diabetic nephropathy is detected clinically by the presence of persistent microalbuminuria or proteinuria. The peak incidence of nephropathy is usually 15-25 years

More information

Nutrition. Type 2 Diabetes: A Growing Challenge in the Healthcare Setting NAME OF STUDENT

Nutrition. Type 2 Diabetes: A Growing Challenge in the Healthcare Setting NAME OF STUDENT 1 Nutrition Type 2 Diabetes: A Growing Challenge in the Healthcare Setting NAME OF STUDENT 2 Type 2 Diabetes: A Growing Challenge in the Healthcare Setting Introduction and background of type 2 diabetes:

More information

TYPE 2 DIABETES MELLITUS: NEW HOPE FOR PREVENTION. Robert Dobbins, M.D. Ph.D.

TYPE 2 DIABETES MELLITUS: NEW HOPE FOR PREVENTION. Robert Dobbins, M.D. Ph.D. TYPE 2 DIABETES MELLITUS: NEW HOPE FOR PREVENTION Robert Dobbins, M.D. Ph.D. Learning Objectives Recognize current trends in the prevalence of type 2 diabetes. Learn differences between type 1 and type

More information

Insulin Pump Therapy for Type 1 Diabetes

Insulin Pump Therapy for Type 1 Diabetes Insulin Pump Therapy for Type 1 Diabetes Aim(s) and objective(s) This guideline has been developed to describe which patients with Type 1 Diabetes should be referred for assessment for insulin pump therapy

More information

Understanding diabetes Do the recent trials help?

Understanding diabetes Do the recent trials help? Understanding diabetes Do the recent trials help? Dr Geoffrey Robb Consultant Physician and Diabetologist CMO RGA UK Services and Partnership Assurance AMUS 25 th March 2010 The security of experience.

More information

Diabetes mellitus. Lecture Outline

Diabetes mellitus. Lecture Outline Diabetes mellitus Lecture Outline I. Diagnosis II. Epidemiology III. Causes of diabetes IV. Health Problems and Diabetes V. Treating Diabetes VI. Physical activity and diabetes 1 Diabetes Disorder characterized

More information

Patient Type 2 Diabetes

Patient Type 2 Diabetes Patient Type 2 Diabetes Aboriginal Health Workers Audiologists Chiropractors Diabetes Educators Dietitians Exercise Physiologists Mental Health Nurses Mental Health Social Workers Occupational Therapists

More information

Diabetes Questionnaire

Diabetes Questionnaire Diabetes Questionnaire UFS Duty of Disclosure (Insurance Contracts Act 1984) Your Duty of Disclosure Before you enter into a contract of life insurance with an insurer, you have a duty, under the Insurance

More information

Understanding Diabetes

Understanding Diabetes Understanding Diabetes What is diabetes? Diabetes is a condition where there is too much glucose (a type of sugar) in your blood. Your blood glucose level is regulated with the help of insulin, a hormone

More information

Traditionally, patients newly

Traditionally, patients newly Primary/secondary care interface Nurse-led management of newly diagnosed type 2 diabetes Joan Everett and David Kerr Article points 1The diagnosis of diabetes can have a profound psychological impact upon

More information

DIABETES YOUR GUIDE TO

DIABETES YOUR GUIDE TO YOUR GUIDE TO DIABETES b What is diabetes? b Type 2 diabetes prevention b Prevention checklist b Living with diabetes b Complications b Terms to know b Resources To promote and protect the health of Canadians

More information

Information Guide For GPs and Practice Nurses

Information Guide For GPs and Practice Nurses Information Guide For GPs and Practice Nurses What is HEAL? HEAL is an 8-week lifestyle modification program that supports people to develop lifelong healthy eating and physical activity habits. The program

More information

The Family Library. Understanding Diabetes

The Family Library. Understanding Diabetes The Family Library Understanding Diabetes What is Diabetes? Diabetes is caused when the body has a problem in making or using insulin. Insulin is a hormone secreted by the pancreas and is needed for the

More information

Type 2 Diabetes. What is diabetes? Understanding blood glucose and insulin. What is Type 2 diabetes? Page 1 of 5

Type 2 Diabetes. What is diabetes? Understanding blood glucose and insulin. What is Type 2 diabetes? Page 1 of 5 Page 1 of 5 Type 2 Diabetes Type 2 diabetes occurs mainly in people aged over 40. The 'first-line' treatment is diet, weight control and physical activity. If the blood glucose level remains high despite

More information

Diabetes and Hypertension Care For Adults in Primary Care Settings

Diabetes and Hypertension Care For Adults in Primary Care Settings and Hypertension Care For Adults in Primary Care Settings What is Type 2? The carbohydrates including sugar and starch which we take become glucose after digestion. It will then be absorbed by the small

More information

DIABETES MELLITUS. By Tracey Steenkamp Biokineticist at the Institute for Sport Research, University of Pretoria

DIABETES MELLITUS. By Tracey Steenkamp Biokineticist at the Institute for Sport Research, University of Pretoria DIABETES MELLITUS By Tracey Steenkamp Biokineticist at the Institute for Sport Research, University of Pretoria What is Diabetes Diabetes Mellitus (commonly referred to as diabetes ) is a chronic medical

More information

what is diabetes? Talking diabetes No.42

what is diabetes? Talking diabetes No.42 Talking diabetes No.42 what is diabetes? Revised 2012 Diabetes is the name given to a group of different conditions in which there is too much glucose (sugar) in the blood. The pancreas either cannot make

More information

Part B: 3 3. DIABETES MELLITUS. 3.1.1 Effects of diabetes on driving. 3.1.2 Evidence of crash risk. 3.2.1 Hypoglycaemia

Part B: 3 3. DIABETES MELLITUS. 3.1.1 Effects of diabetes on driving. 3.1.2 Evidence of crash risk. 3.2.1 Hypoglycaemia 3. DIABETES MELLITUS Refer also to section 6 Neurological conditions, section 2 Cardiovascular conditions, section 8 Sleep disorders section 10 Vision eye disorders. 3.1 Relevance to the driving task 3.1.1

More information

Fact Sheet for General Practitioner and Practice Nurses Health assessments for people with intellectual disabilities: opportunities for better health

Fact Sheet for General Practitioner and Practice Nurses Health assessments for people with intellectual disabilities: opportunities for better health Fact Sheet for General Practitioner and Practice Nurses Health assessments for people with intellectual disabilities: opportunities for better health This document is designed to facilitate the use of

More information

D I D Y O U K N O W? D I A B E T E S R E S O U R C E G U I D E. Blindness Heart Disease Strokes Kidney Failure Amputation

D I D Y O U K N O W? D I A B E T E S R E S O U R C E G U I D E. Blindness Heart Disease Strokes Kidney Failure Amputation D I D Y O U K N O W? D I A B E T E S R E S O U R C E G U I D E Diabetes is a serious disease that can lead to Blindness Heart Disease Strokes Kidney Failure Amputation Diabetes kills almost 210,000 people

More information

'What do they do? The role of mental health nurses in general practice. Kim Ryan Chief Executive Officer Australian College of Mental Health Nurses

'What do they do? The role of mental health nurses in general practice. Kim Ryan Chief Executive Officer Australian College of Mental Health Nurses 'What do they do? The role of mental health nurses in general practice Kim Ryan Chief Executive Officer Australian College of Mental Health Nurses 1 Hearing loss, vision problems and mental disorders are

More information

Absolute cardiovascular disease risk assessment

Absolute cardiovascular disease risk assessment Quick reference guide for health professionals Absolute cardiovascular disease risk assessment This quick reference guide is a summary of the key steps involved in assessing absolute cardiovascular risk

More information

Causes, incidence, and risk factors

Causes, incidence, and risk factors Causes, incidence, and risk factors Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes,

More information

Statistics of Type 2 Diabetes

Statistics of Type 2 Diabetes Statistics of Type 2 Diabetes Of the 17 million Americans with diabetes, 90 percent to 95 percent have type 2 diabetes. Of these, half are unaware they have the disease. People with type 2 diabetes often

More information

Diabetes and Life Insurance. A Special Report by LifeInsure.co.uk

Diabetes and Life Insurance. A Special Report by LifeInsure.co.uk Diabetes and Life Insurance A Special Report by LifeInsure.co.uk Introduction Securing life insurance as a diabetic can be a difficult and costly process. Many insurers will refuse cover, or will set very

More information

DIABETES A chronic, debilitating and often deadly disease A global epidemic Diabetes in Africa

DIABETES A chronic, debilitating and often deadly disease A global epidemic Diabetes in Africa DIABETES A chronic, debilitating and often deadly disease Diabetes is a chronic condition that arises when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin

More information

Summary of new Medicare Benefits Schedule (MBS) item numbers: general practice and allied health. Updated April 2013

Summary of new Medicare Benefits Schedule (MBS) item numbers: general practice and allied health. Updated April 2013 Summary of new Medicare Benefits Schedule (MBS) item numbers: general practice and allied health Updated April 2013 If you would like to receive this publication in an accessible format please phone (03)

More information

Diabetes 101: A Brief Overview of Diabetes and the American Diabetes Association What Happens When We Eat?

Diabetes 101: A Brief Overview of Diabetes and the American Diabetes Association What Happens When We Eat? Diabetes 101: A Brief Overview of Diabetes and the American Diabetes Association What Happens When We Eat? After eating, most food is turned into glucose, the body s main source of energy. 1 Normal Blood

More information

Insulin-Treated Diabetes. Guidelines for assessment of fitness to work as Cabin Crew

Insulin-Treated Diabetes. Guidelines for assessment of fitness to work as Cabin Crew Insulin-Treated Diabetes Guidelines for assessment of fitness to work as Cabin Crew General Considerations As with all medical guidelines it is important that each individual case is assessed on its own

More information

Welcome to Diabetes Education! Why Should I Take Control of My Diabetes?

Welcome to Diabetes Education! Why Should I Take Control of My Diabetes? Welcome to Diabetes Education! Why Should I Take Control of My Diabetes? NEEDS and BENEFITS of SELF-MANAGEMENT You make choices about your life and health Controlling diabetes needs every day decisions

More information

CHAPTER V DISCUSSION. normal life provided they keep their diabetes under control. Life style modifications

CHAPTER V DISCUSSION. normal life provided they keep their diabetes under control. Life style modifications CHAPTER V DISCUSSION Background Diabetes mellitus is a chronic condition but people with diabetes can lead a normal life provided they keep their diabetes under control. Life style modifications (LSM)

More information

Townsville NBN diabetes in-home monitoring trial Dr Karen Carlisle Townsville-Mackay Medicare Local

Townsville NBN diabetes in-home monitoring trial Dr Karen Carlisle Townsville-Mackay Medicare Local Townsville NBN diabetes in-home monitoring trial Dr Karen Carlisle Townsville-Mackay Medicare Local The Trial is supported by funding from the Australian Government under the Digital Regions Initiative

More information

Post-Transplant Diabetes: What Every Patient Needs to Know

Post-Transplant Diabetes: What Every Patient Needs to Know Post-Transplant Diabetes: What Every Patient Needs to Know International Transplant Nurses Society What is Diabetes? Diabetes is an illness that effects how your body makes and uses a hormone called insulin.

More information

Guidelines for the management of hypertension in patients with diabetes mellitus

Guidelines for the management of hypertension in patients with diabetes mellitus Guidelines for the management of hypertension in patients with diabetes mellitus Quick reference guide In the Eastern Mediterranean Region, there has been a rapid increase in the incidence of diabetes

More information

Management of Children with newly diagnosed type 1 diabetes (up until their 18th Birthday)

Management of Children with newly diagnosed type 1 diabetes (up until their 18th Birthday) Title: Author: Speciality / Division: Directorate: CLINICAL GUIDELINES ID TAG Management of Children with newly diagnosed type 1 diabetes (up until their 18th Birthday) Dr Teresa Mulroe and Dr Sarinda

More information

Type 1 diabetes and eating disorders

Type 1 diabetes and eating disorders Type 1 diabetes and eating disorders The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered by Diabetes Australia. 1 Eating disorders are a considerable

More information

TYPE 2 DIABETES IN CHILDREN DIAGNOSIS AND THERAPY. Ines Guttmann- Bauman MD Clinical Associate Professor, Division of Pediatric Endocrinology, OHSU

TYPE 2 DIABETES IN CHILDREN DIAGNOSIS AND THERAPY. Ines Guttmann- Bauman MD Clinical Associate Professor, Division of Pediatric Endocrinology, OHSU TYPE 2 DIABETES IN CHILDREN DIAGNOSIS AND THERAPY Ines Guttmann- Bauman MD Clinical Associate Professor, Division of Pediatric Endocrinology, OHSU Objectives: 1. To discuss epidemiology and presentation

More information

OPERATIONAL GUIDELINES FOR ACCESS TO ALLIED PSYCHOLOGICAL SERVICES (ATAPS) TIER 2 ABORIGINAL AND TORRES STRAIT ISLANDERS MENTAL HEALTH SERVICES

OPERATIONAL GUIDELINES FOR ACCESS TO ALLIED PSYCHOLOGICAL SERVICES (ATAPS) TIER 2 ABORIGINAL AND TORRES STRAIT ISLANDERS MENTAL HEALTH SERVICES DRAFT OPERATIONAL GUIDELINES FOR ACCESS TO ALLIED PSYCHOLOGICAL SERVICES (ATAPS) TIER 2 ABORIGINAL AND TORRES STRAIT ISLANDERS MENTAL HEALTH SERVICES APRIL 2012 Mental Health Services Branch Mental Health

More information

Population Health Management Program

Population Health Management Program Population Health Management Program Program (formerly Disease Management) is dedicated to improving our members health and quality of life. Our Population Health Management Programs aim to improve care

More information

Type 1 Diabetes ( Juvenile Diabetes)

Type 1 Diabetes ( Juvenile Diabetes) Type 1 Diabetes W ( Juvenile Diabetes) hat is Type 1 Diabetes? Type 1 diabetes, also known as juvenile-onset diabetes, is one of the three main forms of diabetes affecting millions of people worldwide.

More information

LC Paper No. CB(2)626/12-13(04) For discussion on 18 February 2013. Legislative Council Panel on Health Services

LC Paper No. CB(2)626/12-13(04) For discussion on 18 February 2013. Legislative Council Panel on Health Services LC Paper No. CB(2)626/12-13(04) For discussion on 18 February 2013 Legislative Council Panel on Health Services Elderly Health Assessment Pilot Programme PURPOSE This paper briefs Members on the Elderly

More information

Baskets of Care Diabetes Subcommittee

Baskets of Care Diabetes Subcommittee Baskets of Care Diabetes Subcommittee Disclaimer: This background information is not intended to be a comprehensive scientific discussion of the topic, but rather an attempt to provide a baseline level

More information

Nutrition Therapy in Diabetes Mellitus. Dorothy Debrah Diabetes Specialist Dietitian University Hospital, Llandough. Wales, UK February 2012

Nutrition Therapy in Diabetes Mellitus. Dorothy Debrah Diabetes Specialist Dietitian University Hospital, Llandough. Wales, UK February 2012 Nutrition Therapy in Diabetes Mellitus. Dorothy Debrah Diabetes Specialist Dietitian University Hospital, Llandough. Wales, UK February 2012 University Hospital Llandough DIABETES MELLITUS. Definition:

More information

An Overview and Guide to Healthy Living with Type 2 Diabetes

An Overview and Guide to Healthy Living with Type 2 Diabetes MEETING YOUR GOALS An Overview and Guide to Healthy Living with Type 2 Diabetes MEETING YOUR GOALS This brochure was designed to help you understand the health goals to live a healthy lifestyle with type

More information

STATE OF THE NATION. Challenges for 2015 and beyond. England

STATE OF THE NATION. Challenges for 2015 and beyond. England STATE OF THE NATION Challenges for 2015 and beyond England The state of the nation: diabetes in 2014 4 Care for children and young people 28 The challenges for 2015 and beyond: what needs to happen over

More information

Diabetes Foot Screening and Risk Stratification Tool

Diabetes Foot Screening and Risk Stratification Tool Diabetes Foot Screening and Risk Stratification Tool Welcome to the Diabetes Foot Screening and Risk Stratification Tool This tool is based on the work of the Scottish Foot Action Group (SFAG). It has

More information

NZSSD Position Statement on the diagnosis of, and screening for, Type 2 Diabetes

NZSSD Position Statement on the diagnosis of, and screening for, Type 2 Diabetes NZSSD Position Statement on the diagnosis of, and screening for, Type 2 Diabetes Updated: September 2011 This 2011 statement is a guide for health practitioners and complements 2003 and 2009 formal guidelines

More information

Exceptional People. Exceptional Care. Antenatal Appointment Schedule for Normal Healthy Women with Singleton Pregnancies

Exceptional People. Exceptional Care. Antenatal Appointment Schedule for Normal Healthy Women with Singleton Pregnancies Exceptional People. Exceptional Care. Antenatal Appointment Schedule for Normal Healthy Women with Singleton Pregnancies First Antenatal Contact with the GP Obtain medical and obstetric history. Measure

More information

Treatment of diabetes In order to survive, people with type 1 diabetes must have insulin delivered by a pump or injections.

Treatment of diabetes In order to survive, people with type 1 diabetes must have insulin delivered by a pump or injections. National Diabetes Statistics What is diabetes? Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.

More information

WHAT IS DIABETES MELLITUS? CAUSES AND CONSEQUENCES. Living your life as normal as possible

WHAT IS DIABETES MELLITUS? CAUSES AND CONSEQUENCES. Living your life as normal as possible WHAT IS DIABETES MELLITUS? CAUSES AND CONSEQUENCES DEDBT01954 Lilly Deutschland GmbH Werner-Reimers-Straße 2-4 61352 Bad Homburg Living your life as normal as possible www.lilly-pharma.de www.lilly-diabetes.de

More information

DIABETES MELLITUS TYPE 2 PROTOCOL CELLO

DIABETES MELLITUS TYPE 2 PROTOCOL CELLO DIABETES MELLITUS TYPE 2 PROTOCOL CELLO Leiden November 2010 Mw. M. van Mierlo, practice nurse Mw. C. Gieskes, diabetes nurse 1 Contents Introduction 1. Way of working at CELLO for patients with Diabetes

More information

Management of Diabetes Mellitus in Custody

Management of Diabetes Mellitus in Custody Recommendations The medico-legal guidelines and recommendations published by the Faculty are for general information only. Appropriate specific advice should be sought from your medical defence organisation

More information

Health Technology Appraisal- Continuous subcutaneous insulin infusion for the treatment of diabetes (review)

Health Technology Appraisal- Continuous subcutaneous insulin infusion for the treatment of diabetes (review) Health Technology Appraisal- Continuous subcutaneous insulin infusion for the treatment of diabetes (review) Submission on behalf of British Dietetic Association (BDA) Following consultation with the BDA

More information

DHS Primary Health Branch

DHS Primary Health Branch DHS Primary Health Branch Revised Chronic Disease Management Program Guidelines for Primary Care Partnerships and Primary Health Care Services October 2008 These revised Guidelines are based upon the Chronic

More information

Jill Malcolm, Karen Moir

Jill Malcolm, Karen Moir Evaluation of Fife- DICE: Type 2 diabetes insulin conversion Article points 1. Fife-DICE is an insulin conversion group education programme. 2. People with greater than 7.5% on maximum oral therapy are

More information

Diabetes and pregnancy - Antenatal care

Diabetes and pregnancy - Antenatal care All of our publications are available in different languages, larger print, braille (English only), audio tape or another format of your choice. Information for you Tha gach sgrìobhainn againn rim faotainn

More information

INDIGENOUS CHRONIC DISEASE PACKAGE CARE COORDINATION AND SUPPLEMENTARY SERVICES PROGRAM GUIDELINES

INDIGENOUS CHRONIC DISEASE PACKAGE CARE COORDINATION AND SUPPLEMENTARY SERVICES PROGRAM GUIDELINES CLOSING THE GAP tackling disease INDIGENOUS CHRONIC DISEASE PACKAGE CARE COORDINATION AND SUPPLEMENTARY SERVICES PROGRAM GUIDELINES November 2012 CONTENTS 1. Introduction... 3 Program Context... 3 Service

More information

Diabetes Coaching: A nurse-led approach for better selfmanagement of patients with diabetes in Primary Care

Diabetes Coaching: A nurse-led approach for better selfmanagement of patients with diabetes in Primary Care Diabetes Coaching: A nurse-led approach for better selfmanagement of patients with diabetes in Primary Care Submission for the 2014 Canterbury DHB Quality Improvement and Innovation Awards Te Rawhiti Family

More information

PowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY. 12a. FOCUS ON Your Risk for Diabetes. Copyright 2011 Pearson Education, Inc.

PowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY. 12a. FOCUS ON Your Risk for Diabetes. Copyright 2011 Pearson Education, Inc. PowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY 12a FOCUS ON Your Risk for Diabetes Your Risk for Diabetes! Since 1980,Diabetes has increased by 50 %. Diabetes has increased by 70 percent

More information

Diabetes and exercise

Diabetes and exercise Diabetes and exercise Summary Symptoms of hypoglycaemia are caused by low blood sugar. Hypoglycaemia can occur if you take your diabetes medication and then do not eat enough or exercise more than usual.

More information

Diabetes in Primary Care course MCQ Answers 2016

Diabetes in Primary Care course MCQ Answers 2016 Diabetes in Primary Care course MCQ Answers 2016 Diagnosis of Diabetes HbA1C should not be used as a diagnostic tool in the following situations: (answer each TRUE or FALSE) 1. Gestational Diabetes TRUE

More information

Diabetes and stroke. What is diabetes? What are the symptoms of diabetes? Stroke Helpline: 0303 3033 100 Website: stroke.org.uk

Diabetes and stroke. What is diabetes? What are the symptoms of diabetes? Stroke Helpline: 0303 3033 100 Website: stroke.org.uk Stroke Helpline: 0303 3033 100 Website: stroke.org.uk Diabetes and stroke Diabetes is a condition caused by too much sugar in your blood. There are over three million people in the UK who have diabetes.

More information

Diabetes Management in General Practice. Guidelines for Type 2 Diabetes. Diabetes 2012/13

Diabetes Management in General Practice. Guidelines for Type 2 Diabetes. Diabetes 2012/13 Diabetes Management in General Practice Guidelines for Type 2 Diabetes Diabetes 2012/13 An electronic version of these guidelines is available at www.diabetesaustralia.com.au Any changes after the printing

More information

Risk Factor. Management. Health Program

Risk Factor. Management. Health Program Risk Factor Management Health Program Risk Factor Management program The Risk Factor Management program is designed for people with risk factors for type 2 diabetes or heart disease. An experienced Health

More information

Diabetes : Foot Education

Diabetes : Foot Education Diabetes : Foot Education Dr. Naushira Pandya, M.D., CMD, Sweta Tewary, PhD, MSW Department of Geriatrics Nova Southeastern University Florida Coastal Geriatric Resources, Education, and Training Center

More information

Scottish Diabetes Survey 2014. Scottish Diabetes Survey Monitoring Group

Scottish Diabetes Survey 2014. Scottish Diabetes Survey Monitoring Group Scottish Diabetes Survey 2014 Scottish Diabetes Survey Monitoring Group Contents Table of Contents Contents... 2 Foreword... 4 Executive Summary... 6 Prevalence... 8 Undiagnosed diabetes... 21 Duration

More information

Type 2 Diabetes workshop notes

Type 2 Diabetes workshop notes Group 1 notes Abi / Nicole Type 2 Diabetes workshop notes 4.1 Population The group discussed the following sub groups that may need addressing: Men-as they tend to die earlier compared with women, their

More information

Diabetes and the Kidneys

Diabetes and the Kidneys Diabetes and the Kidneys Aim(s) and objective(s) This guideline focuses on the detection, prevention, and management of kidney disease in people with diabetes. The management of end-stage renal disease

More information

DCCT and EDIC: The Diabetes Control and Complications Trial and Follow-up Study

DCCT and EDIC: The Diabetes Control and Complications Trial and Follow-up Study DCCT and EDIC: The Diabetes Control and Complications Trial and Follow-up Study National Diabetes Information Clearinghouse U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH What

More information

North of Tyne Area Prescribing Committee

North of Tyne Area Prescribing Committee North of Tyne Area Prescribing Committee ANTIPSYCHOTICS IN PSYCHOSIS, BIPOLAR DISORDER AND AUGMENTATION THERAPY IN TREATMENT RESISTANT DEPRESSION Information for Primary Care Updated November 2013 This

More information

Self-Monitoring Of Blood Glucose (SMBG)

Self-Monitoring Of Blood Glucose (SMBG) Self-Monitoring Of Blood Glucose (SMBG) Aim(s) and objective(s) It is important is to ensure that people with Diabetes are given the opportunity to self monitor their blood glucose appropriately as an

More information

Scottish Diabetes Survey 2013. Scottish Diabetes Survey Monitoring Group

Scottish Diabetes Survey 2013. Scottish Diabetes Survey Monitoring Group Scottish Diabetes Survey 2013 Scottish Diabetes Survey Monitoring Group Contents Contents... 2 Foreword... 4 Executive Summary... 6 Prevalence... 8 Undiagnosed diabetes... 18 Duration of Diabetes... 18

More information

Guideline for Microalbuminuria Screening

Guideline for Microalbuminuria Screening East Lancashire Diabetes Network Guideline for Microalbuminuria Screening Produced by: Task and Finish Group, Clinical Standards Group Produced: August 2006 Approved by: East Lancashire Diabetes Network

More information

An Overview of Medicare Covered Diabetes Supplies and Services

An Overview of Medicare Covered Diabetes Supplies and Services News Flash - Understanding the Remittance Advice: A Guide for Medicare Providers, Physicians, Suppliers, and Billers serves as a resource on how to read and understand a Remittance Advice (RA). Inside

More information

This information explains the advice about type 2 diabetes in adults that is set out in NICE guideline NG28.

This information explains the advice about type 2 diabetes in adults that is set out in NICE guideline NG28. Information for the public Published: 2 December 2015 nice.org.uk About this information NICE guidelines provide advice on the care and support that should be offered to people who use health and care

More information

Connecticut Diabetes Statistics

Connecticut Diabetes Statistics Connecticut Diabetes Statistics What is Diabetes? State Public Health Actions (1305, SHAPE) Grant March 2015 Page 1 of 16 Diabetes is a disease in which blood glucose levels are above normal. Blood glucose

More information

Diabetes and eating disorders

Diabetes and eating disorders Diabetes and eating disorders The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered by Diabetes Australia. Eating disorders are a considerable issue for

More information

SHORT CLINICAL GUIDELINE SCOPE

SHORT CLINICAL GUIDELINE SCOPE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SHORT CLINICAL GUIDELINE SCOPE 1 Guideline title Type 2 diabetes: newer agents for blood glucose control in type 2 diabetes 1.1 Short title Type 2

More information

DIABETES DISEASE MANAGEMENT PROGRAM DESCRIPTION FY11 FY12

DIABETES DISEASE MANAGEMENT PROGRAM DESCRIPTION FY11 FY12 DIABETES DISEASE MANAGEMENT PROGRAM DESCRIPTION FY11 FY12 TABLE OF CONTENTS 1. INTRODUCTION.3 2. SCOPE........3 3. PROGRAM STRUCTURE...4 3.1. General Educational Interventions.....4 3.2. Identification

More information

Diabetes Model of Care

Diabetes Model of Care Endocrine Health Network Diabetes Model of Care Prepared by the Endocrine Health Network Working Party January 2008 WA Health Networks Working Together to Create a Healthy WA 1 Department of Health, State

More information

Diabetes: The Numbers

Diabetes: The Numbers Diabetes: The Numbers Changing the Way Diabetes is Treated. What is Diabetes? Diabetes is a group of diseases characterized by high levels of blood glucose (blood sugar) Diabetes can lead to serious health

More information

DIABETES CARE. Advice. Blood Pressure. Cholesterol. Diabetes control. Eyes. Feet. Guardian Drugs

DIABETES CARE. Advice. Blood Pressure. Cholesterol. Diabetes control. Eyes. Feet. Guardian Drugs DIABETES CARE What happens if you follow the Alphabet Strategy? As patients reach their targets, the chances of developing serious complications of diabetes will be reduced! 1 Stroke Eye disease Heart

More information

Policy For The Adjustment Of Insulin Dose For Patients With Diabetes By Diabetes Specialist Dietitians And Cystic Fibrosis Dietitians In NHS Grampian

Policy For The Adjustment Of Insulin Dose For Patients With Diabetes By Diabetes Specialist Dietitians And Cystic Fibrosis Dietitians In NHS Grampian Policy For The Adjustment Of Insulin Dose For Patients With Diabetes By Diabetes Specialist Dietitians And Cystic Fibrosis Dietitians In NHS Grampian Co-ordinators: Advanced Dietitian (Diabetes) Consultation

More information

Type 2 diabetes Definition

Type 2 diabetes Definition Type 2 diabetes Definition Type 2 diabetes is a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes. Causes Diabetes

More information

Diabetes mellitus is a chronic condition that occurs as a result of problems with the production and/or action of insulin in the body.

Diabetes mellitus is a chronic condition that occurs as a result of problems with the production and/or action of insulin in the body. International Diabetes Federation Diabetes Background Information Diabetes mellitus is a chronic condition that occurs as a result of problems with the production and/or action of insulin in the body.

More information

Antipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease

Antipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease Antipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease Professional Tool #1: Screening and Monitoring in a High-Risk Population: Questions and Answers Overview of Cardiometabolic

More information

DR. Trinh Thi Kim Hue

DR. Trinh Thi Kim Hue TYPE 2 DIABETES IN THE CHILD AND ADOLESCENT DR. Trinh Thi Kim Hue CONTENTS Definition Diagnosis Treatment Comorbidities and Complications Comorbidities and Complications Screening for T2D References DEFINITION

More information

Effectiveness of an iphone application on Diabetes Self-Management

Effectiveness of an iphone application on Diabetes Self-Management Effectiveness of an iphone application on Diabetes Self-Management Ms Morwenna Kirwan, Dr. Corneel Vandelanotte, Dr. Mitch Duncan, Dr Andrew Fenning, Prof. Kerry Mummery Institute for Health and Social

More information

Insulin Resistance and PCOS: A not uncommon reproductive disorder

Insulin Resistance and PCOS: A not uncommon reproductive disorder Insulin Resistance and PCOS: A not uncommon reproductive disorder Joyce L. Ross, MSN, CRNP, CS, FNLA, FPCNA Diplomate Accrediation Council for Clinical Lipidology President Preventive Cardiovascular Nurses

More information

SUMMARY OF THE BROAD PURPOSE OF THE POSITION AND ITS RESPONSIBILITIES / DUTIES

SUMMARY OF THE BROAD PURPOSE OF THE POSITION AND ITS RESPONSIBILITIES / DUTIES POSITION DESCRIPTION Credentialled Mental Health Nurse (CMHN) Contractor SUMMARY OF THE BROAD PURPOSE OF THE POSITION AND ITS RESPONSIBILITIES / DUTIES As a contractor to Summit Health s mental health

More information