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Newly diagnosed diabetes mellitus
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First Visit
?Aware of diagnosis – inform
- Feelings
- Health Beliefs
- Concerns
Patient’s knowledge on diabetes
- Aetiology – insulin resistance
- Role of exercise and weight. Their present lifestyle, and negotiate possible
changes.
- Give Balance for Beginners and diet sheet
Driving
- Patient’s need to inform motor insurance - Inform DVLA only if on
hypoglycaemics.
Referrals
- Dietician - letter to Angela
- Retinal Screening – fill in form and put in Anne’s basket
Recall Markers
- Annual review .@!L6 – set date for in a years time
- Diabetic check due .@!C22 – set date for in 3 months time
Next Visit in 2 weeks, and bring with them an EMU, mid-stream.
Second Visit
Patients concerns
- Questions from reading material
Education
- Review changes made to diet, exercise, lifestyle and goals set by patient.
Risk Factors
- BP, BMI
- Other blood results – lipids, creatine (if not done already, include FBC, TFT,
lipids. LFT and U&Es, in next diabetes check with HbA1c)
- Smoking, alcohol.
- Peripheral Pulses and vibration and sensation.
Referrals
- Chiropodist if difficulty with nail cutting, need treatment or at risk feet.
Home Monitoring
- Discuss options
- Patient choice ?show how to test urine/or monitor BMs, may need another
appointment to check if using appropriately.
Screening
- Send EMU to lab for micro-albuminuria
Next Visit – at 3 month check, or earlier if high blood sugars and ?need early
medication.