Welcome to the diabetes intensification clinic.
Here we will work with you to improve control to proceed with your planned surgery..
Frequent questions
- 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
- 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
- Diabetes control is assessed by two factors
- 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
- 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.
- 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?
- 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
- 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.
- 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
- Not always. Many of these clinics are held over telphone. You may need to attend one clinic and the rest will be telephone clinics.
- 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
- 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)
- Advice varies from patient to patient