Welcome to the diabetes intensification clinic.

Here we will work with you to improve control to proceed with your planned surgery..

Frequent questions

  1. How do I know where my diabetes control lies?
    • Diabetes control is assessed by two factors
      • HbA1c– This gives an indication of how good your overall control has been over the past 2 months. This is a strong indicator of your risk of post – operative complications
        • HbA1c 40 – 50 Excellent control
        • HbA1c 50 – 60 – good control
        • HbA1c 60 – 70 Acceptable control
        • HbA1c 70 – 80 Needs improvement
        • HbA1c >80 poor control
  2. How long will this delay surgery?
    • This depends on your level of glucose control. If your diabetes control is acceptable then the Pre- op team will be happy to see you back in pre op clinic to schedule surgery. generally it will take time to bring your glucose levels down.
      • HbA1c 70 – 90 – 2 months
      • HbA1c > 90    – 4 months
    • It will be a mistake to bring your sugars crashing down as your body needs time to readjust to changing glucose control
  3. Will I need to start insulin?
    • Not necessarily. Insulin is required for all patients with type 1 diabetes, but for a few patients with Type 2 diabetes. We focus on the following
      • Lifestyle- we will look into your diet and eating habits
      • Activity. Advise on activity as possible Remember activity is not always required for weight loss or improving control. You canot exercise your way out of poor nutrition
      • Medications Are you on the correct medications?
  4. What about blood glucose monitoring.
    • It is likely that we will set up blood glucose monitoring for 3 months to help you understand the impact of foods on your blood sugars.
  5. Will I need to attend Face to Face clinics ?
    • Not always. Many of these clinics are held over telphone. You may need to attend one clinic and the rest will be telephone clinics.
      • Clinic 1 – Day 0 – With Doctor 30 minute appointment assessing baseline and direction of change
      • Patient initiated contact 2 weeks later
      • Telephone Nurse led clinic 4 weeks later
      • Patient initiated contact 4 weeks later
      • Final Visit 10 weeks Blood tests
    • If HbA1c still above target
      • Patient initiated contact 2 weeks later
      • Telephone Nurse led clinic 4 weeks later
      • Patient initiated contact 4 weeks later
      • Final Visit 20 weeks Blood tests
      • Discharge
  6. What can I do to help?
    • If you are testing blood sugars, please do a glucose profile, ( 4 tests on the same day over different times ( 7 AM, 11 AM, 3 PM and 7 PM)
    • Please bring your blood glucose meter
    • If you can record your sugars in a book that is helpful
    • Eating habits. Please write down your food over the past 24 hours ( including cereals, fruit juice, fruit)
    • Activity
  7. What do we recommend?
    • Advice varies from patient to patient
      • Restrict carbohydrate to match exercise capacity
      • Activity (as tolerated) at least  40 minutes per day
      • Take all your medications as advised, if required set alarms on your phone
      • Write down any concerns or side effects to discuss in clinic
      • Please bring your medication list and blood glucose meter ( if any)