The Diabetes
Consultation
Consultation infrastructure
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| Make available for consultations the following : |
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necessary members of the diabetes team |
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adequate time and adequate space |
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records and information for the individual with diabetes |
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means of communication to other health professionals involved in the
individual's care |
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Consultation
process
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| Include the following in any diabetes consultation : |
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Welcome |
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- Friendly greeting of the individual and early establishment of
rapport
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Problems review |
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Understanding of any recent events disturbing the person's
life-style
- Enquiry after general well-being and identification of new
difficulties
- Review of self-monitored results, and discussion of their meaning
- Review of dietary behaviours and physical activity
- Review of diabetes education, skills, and foot care
- Review of insulin therapy and experience of hypoglycaemia
- Review of other medical conditions and therapy affecting diabetes
- Management of arterial risk factors identified at Annual Review
- Management of complications and other problems identified at Annual
Review
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Analysis and planning |
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Summary of, and agreement on, main points covered in
consultation
- Agreement on targets for future months
- Agreement on, and explanation of, changes in therapy
- Agreement on interval to next consultation
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Recording |
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- Completion of a structured record / patient-held record of the
consultation
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Annual
review
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| Include additionally, at Annual Review, surveillance of
the following: |
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Symptoms of ischaemic heart disease, peripheral vascular
disease, neuropathy, impotence
- Feet including footwear, deformity or poor skin condition, ischaemia,
ulceration, absent pulses, sensory impairment ( see Foot problems )
- Visual acuity
- Retinopathy by ophthalmoscopy / retinal photography ( see Eye damage )
- Kidney damage by albumin excretion and serum creatinine ( see Kidney damage )
- Hypertension ( see Kidney damage )
- Dyslipidaemia ( see Arterial risk factors )
- Injection sites
- Attendance at podiatry / ophthalmology / other if indicated
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