Care from healthcare professionals
Whether you have just been diagnosed or had diabetes for some time it is important that you get the right support for managing your diabetes. This will help to ensure that your diabetes, blood pressure and blood fats are all kept in check, as well as detecting any early signs of complications so that they can be caught and treated successfully.
Your diabetes team will monitor your diabetes control, and you should have a full diabetes check at least once a year.
This check is referred to as your annual diabetes review: its purpose is to check for early signs of complications and to enable you to lead a healthy life. The annual review consists of a few tests, often on different days, and with different healthcare professionals.
As part of your annual review, it is important that you receive a quality foot check from a properly trained person. Find out more about what to expect at your annual foot check.
Getting the most out of your appointments
- decide what you need to know
- write down the points you want to raise
- bring your blood glucose meter and results record with you, if you test
- bring any news features/stories or research that you have any questions about.
- listen actively – ask questions, give feedback and ask for clarification if you’re unsure of anything
- make notes to help you remember what has been said
- check you’ve covered your list.
- review what’s been said and agreed
- make a note of anything you need to do before your next appointme
Care planning review
The annual diabetes review is an ideal time to have your care planning review. Care planning is a process that should be available to all people with diabetes. It:
- allows you to be more involved in decisions about how your diabetes is managed
- gives you a say in every aspect of the care you get
- helps you to work towards goals that are personal to you
- helps you to work in partnership with your diabetes team.
The care planning appointment is a chance to talk about the results of your annual diabetes checks (these are included as part of the 15 healthcare essentials) with your healthcare professional, talk about your experiences and discuss how you feel, set goals, and create an action plan to help you manage your diabetes.
Your healthcare professional can help you to understand the results of your diabetes checks, provide you with information and advice, talk about different options – for example, different types of medication available to you – and refer or signpost you to support in your local area.
A care plan is a written document of all these discussions, goals and actions.
There are a range of tests which will be carried out:
- Blood glucose levels
- Urine testing
- HbA1c (Glycated haemoglobin) or fructosamine
- Blood pressure (hypertension)
- Blood fats (lipids)
- Blood glucose levels
Blood glucose targets
It is important that the blood glucose levels being aimed for are as near normal as possible (that is in the range of those of a person who does not have diabetes). These are:
- 3.5–5.5mmol/l* before meals
- less than 8mmol/l, two hours after meals.
There are many different opinions about the ideal range to aim for. As this is so individual to each person, the target levels must be agreed between the person and their diabetes team.
The target blood glucose ranges below are indicated as a guide.
Children with Type 1 diabetes (NICE 2015)
- on waking and before meals: 4–7mmol/l
- after meals: 5–9mmol/l.
Adults with Type 1 diabetes (NICE 2015)
- on waking: 5–7mmol/l
- before meals at other times of the day: 4–7mmol/l
- 90 minutes after meals: 5–9mmol/l.
Type 2 diabetes (Diabetes UK Council of Healthcare Professionals 2015)
- before meals: 4–7mmol/l
- two hours after meals: less than 8.5mmol/l.
Pregnant women with diabetes (NICE 2015)
- fasting: below 5.3mmol/l
- 1 hour after meals: below 7.8mmol/l or
- 2 hours after meals: below 6.4mmol/l
*millimoles per litre: a measurement of the concentration of a substance in a given amount of liquid.