Diabetes Clinic/Nurse

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Ribenababy

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Relationship to Diabetes
Type 2
Hi Everyone,

Can anyone let me know what the criteria is for being referred to a diabetic clinic or to see a diabetes nurse specialist? Just wondering because so far I am just seeing my GP. I have a blood test scheduled for next week which he said would be used as a baseline for the various things they test for to see how I am getting on with the metformin and weight loss. So far I have lost
6lbs and am managing to reduce my carb intake, although it takes some planning for alternative options so as I am not left feeling hungry. My metformin dose increases to three a day from the end of next week. I do think my medical care has been a bit casual so far, metformin has already been added to my repeat prescriptions so if there are no problems with the blood test next week my metformin and other medication review is not until February 2011 so I guess I can just not go and see a doctor until then if I choose or unless there is something else wrong with me.
 
I don't know what the criteria for referral to a diabetes specialist is, but I would have thought you should have been referred immediately after diagnosis? Perhaps you could approach your hospital directly?

I wouldn't have thought GPs would have had enough specific diabetes training to care for you on their own.
 
My diabetic care is also very casual with my GP. I think sometimes my GP gets a bit upset when I ask questions or if I spot and education programme I'd like to do.

I'd like to transfer my diabetes care to the hospital, but need to do it in such a way that wont upset my doctor as other doctors in my area are a bus ride away and more difficult to get to.
 
Unfortunately I think you will find that Type 2 care is being moved to 'primary care' i.e GP's. This is part of the NHS drive to make it more responsive. Is this a good thing ? Personally I don't think so, but how much choice you have is difficult to say. As a Type 1, i get to stay under the hospital. Part of the issue, is if you are referred to the hospital the GP has to pay the hospital to treat you out of the money they get paid for treating you as a diabetic. Hence the reason they are usually keep to keep you under their treatment. I refuse to be treated by my GP, even though they keep trying, because I don't believe they have a good enough understanding to treat me. I also refuse becuase my consultant is superb and I couldn't get anything like that treatment at the GP's.
Still you a supposed to have a choice nowadays, so why not try. You should also be able to see your Diabetes team ( doctor, DSN etc) any time you need to, you don't need to be ill !
 
As a Type 1 I was referred to the hospital diabetic clinic straight away but my auntie is Type 2 and has always been cared for by her gp/gp practice diabetic clinic. My auntie is now having to go on insulin though and has been referred to the hospital for that reason.

If you feel you would like to speak to your gp about your care then you can make an appointment anytime you like to see them.
 
Hi I was referred to a DSN immediatly after diangosis BUT i had to wait until about May that was 3 months after dignosis before i actually saw her.Have a wrod with your GP if your not happy with your level of care x
 
Ribenababy - are you happy with the care provided by your GP?
It sounds like they and you are doing all the right things, so would a referral to a clinic in a hospital, presumably further away from your home than your GP surgery, really help? If metformin, in combination with diet & exercise & blood glucose monitoring, doesn't control your condition, then there are other medications that can be added by GP. If they proved insufficient, at some time in the future, perhaps never, then GP would refer you to hospital clinic for other (injectable) medications - like Newbs' aunt with T2D. Both GPs and hospital clinics have DSNs (Diabetes Specialist Nurses), although availability and skills do vary between individuals.
If I needed an urgent appointment, I've no idea how long I'd have to wait at hospital, as I only go for annual reviews, but I could get a GP appointment within 48 hrs, although I don't need them either.
 
You might have a practice nurse in your surgery that see's patient with diabetes. With you treatment I doubt you would be referred to a hospital clinic. See if you can find out how it works in your local area,e.g. the DSN's might work in primary care. Not everyone goes to the hospital, lots of type 1's and 2's are cared for well within primary care.

You might benefit from x-pert or DESMOND courses if they are offered in your area.
 
When I was first diagnosed I was referred to my local diabetic unit at the hospital (Beta Cell at Queen Mary's Hospital, Roehampton), types 1 and 2 were seen there.. when I moved as a type 2 I was seen by my GP as it was only diabetics who were on insulin who were seen at the hospital diabetic unit. I was referred to the unit as I needed to go on insulin. Most GP surgeries have a diabetes nurse these days it seems.
 
as far as i know T2 seen by GPs.... T1 hostipal ...my gps has a DSN who we generally see but when i see my gp for other things ie the ear infections we discuss my latest figures and diabetes control aswell
 
My gp referred me to the consultant as soon as I was diagnosed. The consultant has full say in my meds and not the gp. To start with I was seen every 4 weeks and then eventually 8 weeks. Recently he had changed it to every 4 weeks while my insulin was / is sorted. Was on metformin only for first 2 years, now on insulin as well.
 
I was cared for by the GP's nurse until my hba1c went to 10.5 and then she referred me to the hospital diabetic clinic where I now see a consultant, a DSN and a dietician. The doctors at my GP surgery do not seem to have much input into the care of the diabetics. The nurse seemed to make all the decisions and just got prescriptions signed by the doc. I really wish I had been given more infornation right at the start as I didn't take it seriously to begin with.
 
Thanks for your responses. I am not unhappy about my care, just curious as it seems very ad hoc. I just hope the metformin, diet and excercise do the trick and will be interested to see the results when I have my first HB1Ac blood test
 
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