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HB1ac and foot testing procedure

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pm133

Well-Known Member
Relationship to Diabetes
Type 1
Just a quick question.

I should be getting a second Hb1ac test presumably 3 months after initial diagnosis and then every 3 to 6 months after that. Is that done through the GP, the diabetes nurses or do I have to ask for it from one of them?
Same question for a podiatry check.
 
I’d check with your GP re the HbA1C because Covid might be affecting the procedure. Usually I get mine done by phoning my GP, having bloods done there (all the diabetic ones) and the result is sent to my consultant at the hospital ready to discuss at my next appointment.

Re podiatry - my GP offers a ‘diabetic foot check’ to everyone registered with them as diabetic. But if you haven’t had one before, I’d phone and check you’re on their list for this first time.
 
Inka said:
I’d check with your GP re the HbA1C because Covid might be affecting the procedure. Usually I get mine done by phoning my GP, having bloods done there (all the diabetic ones) and the result is sent to my consultant at the hospital ready to discuss at my next appointment.

Re podiatry - my GP offers a ‘diabetic foot check’ to everyone registered with them as diabetic. But if you haven’t had one before, I’d phone and check you’re on their list for this first time.
Click to expand...
Thanks Inka.
I seem to have been forgotten by my Diabetes Nurse about 2 weeks after diagnosis which is fine as I don't really need them at the moment but it's a bit awkward not knowing which of the GP or the DN to contact about things. I'd prefer to go via the GP anyway so I'll make the call in a couple of weeks when my 3 months are up.
 
As a Type 1, are you not under a consultant?
It is my consultant who authorises the tests and I get a blood sample label and plastic envelope sent through with my appointment letter. I then have to make an appointment with the practice nurse to take my blood the week before the appointment with the consultant and give her the label which is marked with everything the consultant wants tested... and usually take along an early morning urine sample to go with the blood sample(s). Then I get the results when I speak to the consultant.
At the moment I am seeing the consultant about every 6 months but I envisage that may become annual after my next one, if I can maintain my "excellent control" as detailed in his report to my GP.
In the early days they like to keep a closer eye on you with more regular 3 monthly checks I think, to see that you are making progress and have an opportunity to get help or iron out any early problems.
 
rebrascora said:
As a Type 1, are you not under a consultant?
It is my consultant who authorises the tests and I get a blood sample label and plastic envelope sent through with my appointment letter. I then have to make an appointment with the practice nurse to take my blood the week before the appointment with the consultant and give her the label which is marked with everything the consultant wants tested... and usually take along an early morning urine sample to go with the blood sample(s). Then I get the results when I speak to the consultant.
At the moment I am seeing the consultant about every 6 months but I envisage that may become annual after my next one, if I can maintain my "excellent control" as detailed in his report to my GP.
In the early days they like to keep a closer eye on you with more regular 3 monthly checks I think, to see that you are making progress and have an opportunity to get help or iron out any early problems.
Click to expand...
I've not been assigned a consultant.
I am tempted to be patient until the New Year to see if someone comes to me first. Either way, I'll push if things don't move from their end.
 
It will depend on where you are @pm133

In normal circumstances I can get my blood tests done at the hospital or my GP Practice. I choose to get them done at the Practice as it gives them some ticks, previously QOF points. I then just emailed my Consultant to let him know that they had been done and he accessed the same results before my appointment. I would then book a review at my Practice where they tickled my feet to check for neuropathy, as well as reviewing my results and I updated them on my current management including pump strategies. This happens automatically if I don’t book it in. But I tend to think it is easier for them if I keep track of things and I just put it in my diary, phone and book.

It was the nurse at the The Practice who identified my Burnout. Difficult to miss as I simply cried and cried whilst trying to talk to her. It was then that I was more honest about how I felt and got help which, along with lovely people on this forum, enabled me to get though it and out the other side. Had it been a telephone call it would probably have simply been ‘your numbers look good’ and ‘yes I am fine’. That is my one concern about the changes due to the pandemic.

Here they are classifying patients into different risk groups according to our management, and how long ago we had our last test done. I was due and HbA1c and had missed the previous one so was asked to go into have bloods done. I have a face to face review later this week as usual. Numbers good but they want to check in with me and check my feet as I do have one side that is numb due to spinal stenosis.
 
Ps
By getting my bloods done at the Practice with their own labels, the results go back to them and I can access these within a couple of days online. They do all the tests that my consultant wants so nothing gets missed out. If I use the Consultant labels I have to wait for my consultant to let me know the results, which seems to waist their time. I also like to know the results before my appointments.
 
SB2015 said:
Ps
By getting my bloods done at the Practice with their own labels, the results go back to them and I can access these within a couple of days online. They do all the tests that my consultant wants so nothing gets missed out. If I use the Consultant labels I have to wait for my consultant to let me know the results, which seems to waist their time. I also like to know the results before my appointments.
Click to expand...
Yes and this is why I would prefer it to go through my GP too.
I don't fancy hanging around for results.
 
My consultant has given me a blood test form before where she’s written in all the blood tests to be done (because the GP diabetes ‘expert’ nurse cocked them up previously) but left the form undated. I’ve then booked my blood test with my GP, given them said form, and they’ve taken the blood and sent them off.

My results have then come back to my GP too (as well as my consultant) and it’s my GP that I’ve phoned to get the results. I then am ready to discuss my results with my consultant at my hospital appointment.

So getting a form from the consultant shouldn’t necessarily delay getting the results. @pm133 If you do go through your GP make sure they’re doing the full diabetic bloods as sometimes they don’t.
 
Where I live (Coventry) if the GP writes the form, results to GP but also to Consultant. If the Consultant writes the form only the Consultant gets them. The GPs are all able to sign in to the hospital system from theirs - but the nurses can't.
 
Similar system here. I get invited to hospital clinic and then I arrange bloods at my surgery. The results *mostly* arrive at the hospital automatically. Occasionally I’ve had HbA1c arranged by the hospital and the results have appeared in my ‘patient access’ which I generally check before any appointment to make sure I take the results with me (in case one of their systems is having a funny turn!)

If you would like an interim HbA1c @pm133 I think you can probably just request one at your surgery? Though they may be trying to limit the number of phlebotomy appointments at the moment.

Are you running sensors? These days I feel my HbA1c is more just ‘belt and braces’ confirmation as I can mostly see how things are going from sensor averages and Time In Range

My annual toe tickle is just part of my 12 month review and the nurse checks pulses/filament sensitivity. I’ve never been sent for separate podiatry.
 
everydayupsanddowns said:
Similar system here. I get invited to hospital clinic and then I arrange bloods at my surgery. The results *mostly* arrive at the hospital automatically. Occasionally I’ve had HbA1c arranged by the hospital and the results have appeared in my ‘patient access’ which I generally check before any appointment to make sure I take the results with me (in case one of their systems is having a funny turn!)

If you would like an interim HbA1c @pm133 I think you can probably just request one at your surgery? Though they may be trying to limit the number of phlebotomy appointments at the moment.

Are you running sensors? These days I feel my HbA1c is more just ‘belt and braces’ confirmation as I can mostly see how things are going from sensor averages and Time In Range

My annual toe tickle is just part of my 12 month review and the nurse checks pulses/filament sensitivity. I’ve never been sent for separate podiatry.
Click to expand...
I'll give them a call in the new year if they've not contacted me.
I'm not on a sensor yet. To make things awkward I don't have a Windows based PC (I use Linux) and I also have no desire to buy a smartphone either. I don't think the DN was impressed by either of those 🙂

Presumably I'll have to wait until a year for the foot check although if I have any issues I'll call my GP.
 
Blood testing does seem to be very dependent on CCG.
I have a hospital based consultant who I usually see once a year. When I leave my appointment, he gives me the blood test form for the next appointment in 12 months time.
When I receive the appointment time, I schedule a blood test at my surgery and dig out the form. By default, the results are sent to the consultant because he requested them but my surgery tick a box somewhere and automatically get a copy.

The practice of giving me the form for a year's time has always surprised me. When I commented to the consultant that I have to be very organised to remember where I filed the form and remember to schedule the blood test, the consultant's reply was "yes, most people aren't that organised". Yet they continue the practice!
 
My GP got in touch this morning.
I've to book a blood test at the surgery in 2 weeks time and they'll get the HBA1c test done for me.
Happy with that. I really don't want to have to second guess whether to phone the diabetes clinic or the GP.
 
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