Welcome
@AamirRehman. I was diagnosed with T1 in February this year so its very early days for me too. All the advice above is great but I agree that is is easy to feel worried, confused and a bit alone. I encourage you to ask any questions here. I find when I do this I get quick friendly encouraging answers. Thankyou very much to everyone who has helped me so far.
For those diagnosed recently I’m interested to understand how NHS support kicks in. My GP does not support Type 1s. I am waiting for first clinic appointment in July. It feels like a long wait to get any help and understand what I should be aiming for in terms of targets etc.
Hello
@CathyFP,
From what I've gleaned over the last 4+ years, Scotland has a fairly different approach to England; I'm not so sure about Wales and NI is certainly different in certain aspects.
For England, despite the transition from GP Surgeries previously answering to Cost Centre Groups (CCGs) my former Surgery in Bucks has a different arrangement in the fine details to my new Medical Centre in Berks. Yet the transition from CCGs to Integrated Care Boards (ICBs) doesn't seem to be rationalising anything, and in my case the new amd much larger Bucks, Oxford and Berks (BOB) ICB should (in theory) have provided a more consistent approach across all 3 counties.
In terms of detail: the NICE Guidance Note (NG17) quite clearly tells GPs to refer T1s to Hospital based Diabetes Teams and the Hospital based Diabetes Nurse Specialists (DSNs). Whereas T2s remain under GP Surgeries (NG28). HOWEVER the confusion arises about who (Hospital or GP) deals with the secondary checks, such as annual feet checks. I am in the middle of trying to nail that down right now as I approach 12 months under a GP at our town medical centre.
Annual eye checks are done externally and that seems to run routinely, once your T1 status has been registered onto that network; some eye tests are now happening bi-annually. That doesn't bother me since my experience has already been that if an optician detects something that should be checked or monitored, then the optician can (and has) the authority to refer me to a Specialist; in my case it was Glaucoma. But if I should have a future eyesight concern I would go straight to an optician get an independent review and see what the outcome is. A GP can only do a superficial review and then refer me if the GP thinks that is necessary.
When I've felt a diabetes related check is needed for some other problem I start with my GP. When the Reception tells me no appointments are available soon, I play my "D joker" and emphasise that I can't or shouldn't wait so long and that resolves matters. When I want unique D advice, say about injection sites or techniques I ask my Hospital based DSN team, either by leaving a phone message or a short e-mail and they get back to me. I've been having a longish period of not very good BG management and wondered if (perhaps uniquely for me) it was to do with diet and poor digestion, so I've just asked my Consultant to refer me to the diabetes dietician; I know a less specialised dietician, which my GP can only refer me to, won't understand my awkward D consequential dietary problems.
So the bottom line, as far as I can see, there is not an England wide consistent approach. But my GP has some responsibility for routine D checks and my Hospital based Consultant is the best person for in depth D reviews. I'm still getting 6 monthly reviews. I was also getting annual D checks at my former GP Surgery; currently very little from my new Medical Centre. My GP is responsible for almost all of my prescriptions and prescription reviews; the exception to that, for me, is my Dexcom G7 CGM which can only be provided by a Hospital. So I get those sent direct from Dexcom under a contract between the Hospital and Dexcom; my repeat prescriptions still includes Libre 2, with a caveat saying should Dexcom G7 not arrive.
Its all a bit clumsy, but I find I can pretty well make it work, partly because I know what support I ought to get and press those buttons accordingly. You might find it helpful to ask your question with an indication of where in UK you are (ideally which geographic ICB you are in).
