Annual review

Your annual review can be compared to an MOT for a car. It is performed to establish how well your diabetes is controlled and to pick up any early signs of the long term complications of diabetes, so that they can be treated appropriately.

• Your weight should be recorded to make sure you’re a healthy weight for your height
• Your urine should be tested for protein, to see how well your kidneys are working
• Your blood should be tested to measure long-term diabetes control (HbA1c)
• You should discuss your diabetes control, including your home monitoring results, which you should bring with you.
• Your blood pressure should be checked
• Your vision should be checked and the back or your eyes examined. A digital photo should be taken of the back of your eyes and, if necessary, you should be referred to an ophthalmologist. Your doctor can arrange this for you. It is likely to happen at a different time and place to your annual review.
• Your legs and feet should be examined to check your circulation and nerve supply, and if necessary, you should be referred to a registered podiatrist/ chiropodist
• You should have the opportunity to discuss how you are coping at work and at home
• You should have the opportunity to review your diet with a nurse or registered dietitian
• Your blood fats (cholesterol and triglycerides) should be tested
• Your injection sites should be examined if you are on insulin

You should see your GP and your practice nurse as well as an optometrist to have your eyes screened for retinopathy. You may also be referred to a registered dietitian and/ or a podiatrist.

Blood glucose control: HbA1c is a measure of your long term blood glucose control. The range to aim for should be below 6.5%

Blood fats: cholesterol and triglyceride levels are measured to get an overall picture of the amount and the types of fat in your blood. The aims are:

Total cholesterol: less than 4mmol/l
Triglycerides less than 1.7mmol/l
LDL (bad) cholesterol less than 2mmol/l
HDL (good) cholesterol more than 1mmol/l for men and 1.2mmol/l for women

If you feel that you need advice between appointments, don’t be afraid to contact your healthcare team to request this. It may be that they can advise you over the phone or perhaps you will need to make an additional appointment to discuss the particular problems you are experiencing.

It is important to remember that your annual review is to enable you to lead a normal and healthy life. It must be about what you want and need as well as what healthcare professionals recommend. If you have particular questions in mind before you go, you may wish to write them down and take them along with you. You can also make a note of the answers so that you can refer back to them if you need to.

You might also want to ask your healthcare team what the outcome of any tests were, such as your HbA1c, cholesterol, blood pressure, retinopathy screening and what the results mean. Patients are often told that the results are ‘fine’ but this isn’t always helpful so don’t be afraid to ask if you’d like to know more. Write down the results so that you can keep track of your progress to help you stay on top of your diabetes.

For more information on what questions to ask during your appointment order a leaflet called “Questions to Ask” from the Department of Health by Phoning: 08701 555 455 or 08700 102 870
Fax: 01623 724 524
Email: dh@prolog.uk.com

Looking after your health when you have diabetes is crucial to preventing some of the complications associated with diabetes.  This involves knowing your blood glucose, blood pressure and blood fat levels as well as the condition of your feet and getting your eyes screened for retinopathy. It’s also about eating well; being active; stopping smoking if you smoke; losing weight if you’re overweight or maintaining your weight if you’re already within the recommended weight range for your height.

Self-care may also mean monitoring your blood glucose levels. Knowing the level of glucose in your blood is useful for when you are trying to control your diabetes. It can help to maintain day to day control, detect hypoglycaemia, assess control during any illness, and helps to provide information that can be used in the prevention of long term complications.

Yes, all results and correspondence written about you should be available on request.

People who treat their diabetes with tablets or insulin are entitled to free prescriptions, and everyone with diabetes is entitled to free NHS sight tests. Having diabetes does not automatically qualify someone for free dental treatment. For more information about healthcare entitlements see leaflet HC11, Are you entitled to help with health costs? Available from the Department of Health literature line on: 0800 555777. 

E-mail: doh@prolog.uk.com