Diabetes Care

This condition is primarily managed by the nurses. They can check your blood glucose readings that you may be testing at home, blood pressure readings, order tests and review them, check any problems you may be encountering and do a medication review for you. They can also advise on things you may wish to consider and discuss things that you may have learned during your journey of discovery. They can also check that you have had your annual retinal screening and feet checks done

The health care assistants can check your height and weight and do any blood tests you may need as well as check your urine sample.

Doctors can see patients whose control remains poor or if you are developing further complications that need careful management or if you are having difficulties due to possible side effects. 

Specialist Diabetic Nurses look after those patients who have particular poor control or those who are being started on insulin therapy. You can learn more about the Diabetes and Vascular service by clicking here.

Pharmacists, podiatrists and opticians also have a wealth of experience and knowledge on the management of diabetes and can give you further tips and helpful advice

There is a blood pressure machine in the waiting room for you to check your blood pressure whenever you come to the practice.

There is also a telephone support line to provide urgent Diabetes advice and telephone support as detailed below

Monday to Friday 8am till 10pm

Weekend and Bank Holidays 9am till 1pm

Telephone advice line 0161-366-2354

You need to know what your target blood pressure (140/80 or 130/70 if you have other complications too) and target cholesterol (less than 5 mmol /l or less than 4 mmol/l ideally) and LDL (less than 3 mmol/l or less than 2mmol/l ideally) and HbA1c (less than 7.5% or less than 6.5% ideally) should be and what other risk factors you have that need to be managed eg whether you smoke or not or if you are obese or whether you suffer with ischaemic heart disease or kidney disease. You also need to know what is expected of you in the course of a year even if your blood pressure and symptoms are well-controlled. Finally you can monitor your own blood pressure, weight and smoking status and blood tests and urine test as a way of seeing how you are doing. This information should be in your GP-held record for you to see.

The typical patient with diabetes which is well controlled needs the following:

1. Fasting blood tests and urinalysis once a year with the healthcare assistant– checking you are not anaemic (Haemoglobin), kidney function (Sodium, Potassium, Urea, Creatinine and eGFR), Liver function tests (ALT, AST, albumin), a measure of how your blood sugars have been on average over the previous 3 months (HbA1c),  lipid profile (Cholesterol, HDL, LDL, triglycerides). Thyroid function tests (Thyroxine, TSH) and urinalysis (dip stick urine checking for protein and blood) as well as microalbuminuria
2. Blood Pressure reading at least twice a year 6 months apart. You can do this on your own! This is the minimum needed but you are encouraged to do this more often by using the practice blood pressure machine in the waiting room or buying a blood pressure machine yourself so that you can monitor it at home / work yourself. The local pharmacies all sell reasonably priced blood pressure machines and can give you more details about them.
3. Medication Review every 6 months usually with the nurse if you have good control or every 3 months if you have poor control

As this is a new way of working, it is worth discussing this with the nurse to see how this can be done the first time you decide to take control.

1. Get access to your GP-held record. Without knowing what is in your records and what you need to do, it will be very hard to know what to do when and with who. This is an essential first step for anybody with any condition or who wants the best from the practice.
2. Ideally we want you to book in with the healthcare assistant for fasting blood tests and urine test if you have not had them done for 6 months or prior to your next medication review. At the same time, ask to book in with the nurse a week later. The nurse will check your records and book you in for you. (This is because the nurse needs to check who is the most appropriate person to do the medication review dependent on what else you may also suffer with).
3. Remember to ask for a yellow topped urine bottle from the receptionist which you can bring with you when you have your blood tests. You can do this when you turn up to the surgery and are waiting for the healthcare assistant or bring it with you. This needs to be checked once a year for microalbuminuria
4. Bring your blood pressure readings and weight with you to show to the nurse or doctor if you have been checking them at home.
5. Record your blood pressure twice a day for a week and then take an average of your readings. Ideally you could download a form from here and bring them when you see the doctor or nurse. 
6. Also make a note of when you had your retinal screening done and had your feet checked by the podiatrist.
7. Look at the web page – pre-consultation care – and go through it prior to your review with the clinician. This can help us to understand your needs better and what you want out of the consultation. If there are no specific issues AND all the tests are normal and you are well-controlled, it may even be possible to conduct the medication review over the telephone. This must be with the agreement of the clinician and if you are happy with this. We think many people may benefit from this but we do not want to prevent anybody from coming to the surgery of they so wish.. Understanding your needs is key to a successful outcome of the medication review. See the above mentioned websites to help you to understand what your needs are. Initially you may need the clinician to help you understand how to look at the websites and what they mean for you.