Introduction
Diabetes is a key topic for us at Blackheath. As a disease it is becoming more common, and there are now over twice as many diabetics than there were 10 to 15 years ago.
As a surgery, we aim to diagnose diabetes as early as possible, and to ensure that our patients with diabetes receive the best possible care and advice.
Why is diabetes important?
Diabetes is associated with a significant increase in the risk of developing heart disease (heart attacks and angina), strokes, blocked leg arteries (leading to a risk of amputation), severe eye problems, and serious kidney problems.
Diabetes can affect the eyesight, forcing some to stop driving. It is the leading cause of blindness in the UK.
Diagnosing diabetes as early as possible and managing it effectively helps to reduce the risk of developing these important complications.
Diagnosing diabetes as early as possible
The preferred screening test is a blood test.
We check for diabetes on most blood tests done in the surgery. Additionally, our computer system calculates the patient’s QDiabetes risk score during consultations, and prompts the clinician if a diabetes check is appropriate.
For more information about QDiabetes, please click here to visit the QDiabetes website.
If a screening test comes back abnormal, patients will be invited to have further tests.
The most important thing most people can do to reduce their risk of developing diabetes is to lose weight – most of our diabetics are overweight at the time of diagnosis. Taking more exercise is also important – a 20 minute walk as briskly as you can at least three days weekly at the very least.
Optimising care of known diabetics
Diabetes requires significant patient involvement to ensure best management. We see it all in the surgery, from the patients who do not modify what they eat, requiring more and more drugs for their worsening diabetes and developing diabetic complications, to those who really take the bull by the horns, modify their diet, take more exercise, and require fewer or no drugs.
Those that lose weight, take more exercise to the best of their ability, and switch to a low carbohydrate diet significantly reduce their risk of developing complications.
Benefits of maximising diabetes care
- Reduce the risk of premature death.
- Reduce the risk of vascular disease. Diabetes is associated with a higher risk of heart disease and peripheral vascular disease. The heart disease can include angina and heart attacks. Peripheral vascular disease can limit the patient’s ability to walk any distance, and in bad cases, can lead to lower limb amputation.
- Avoid eyesight problems that might stop the patient driving, or cause blindness.
- Make sure you are fit for whatever else life throws your way. Patients with poorly controlled diabetes can be declared ‘unfit for surgery’. For most operations, the HbA1c test result needs to be less than 65mmol/mol. Some operations require this result to be less than 50mmol/ml. Being declared ‘not fit for surgery’ is quite a challenging and stressful event.
- Reduce the risk of peripheral neuropathy, which means you cannot feel things with your hands and feet.
- Protects the kidneys and reduce the risk of renal impairment and, in bad cases, kidney failure.
What we will do to help you
- Advise you about what you can do to help your diabetes. The fundamental advice is: lose weight and take more exercise.
- Encourage you to stop smoking. Smoking and diabetes is not a good mix. We can refer you to the local smoking cessation service to help you dump the weed before it dumps you.
- Refer you to other specialists, such as dietitians, opticians, podiatrists, community-based diabetic liaison nurses, and hospital-based consultant diabetologists when necessary.
- Advise you to have blood tests at regular intervals. We will also advise annual urine tests (ACR) to check your kidney function.
- Prescribe whatever is needed to optimise your diabetic care. Prescriptions often include medications to help your cholesterol and your blood pressure which both have to be strictly managed. Most maturity-onset diabetics are managed with tablet medication; sometimes GLP1 injections are added to the treatment plan. Some do require insulin therapy.
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Page last reviewed: 11 March 2024