1. Established Type 1 Diabetes Mellitus
GP to refer to secondary care and DSN
Barts
Consultant and/or DSN and/or DSD
Homerton Consultant
Initial appointment with DSN:
Exploration / assessment
Physical exam – injection sites
Review glucose readings and regime
Discuss hypoglycaemia – leaflets x 2
Driving – give leaflet
Alcohol
Correction doses
Sick day rules – give leaflet
Ensure referred to secondary care and retinal screening
Preconception planning – SAFER leaflet
Offer psychology referral and type 1 support group session
Refer to Diabetes Specialist Dietitian
Refer to
BHICEP (>1 year after diagnosis)
and
Carb Counting
If not suitable for pump therapy DSN to continue reviewing as needed
Follow up appointments with DSN:
Review glucose levels and insulin regime
Discuss pump therapy if:
Persistent hypos
HBA1c > 69mmol/mol (8.5%) on basal / bolus regime
If suitable, refer to Jackie Logue
(Pump Demo administrator)