High Risk of Diabetes

Each year in the UK, 5% to 10% of people diagnosed with pre-diabetes go on to develop type 2 diabetes. People with pre-diabetes will often have no symptoms, but have an increased risk of diabetes and heart disease.

What is Pre-diabetes?

Pre-diabetes is also called Impaired Glucose Tolerance. Like diabetes, pre-diabetes is a condition where the amount of glucose (sugar) in the blood is too high and the body cannot use it properly. The glucose levels are not high enough at this stage to be diagnosed with diabetes.

In pre-diabetes, the pancreas (an organ in the body) does not produce enough insulin or the insulin that is produced doesn’t work properly. Insulin is a hormone in the blood which lowers and controls blood glucose level. This is often the result of carrying extra fat around the waist area.

Either a fasting plasma glucose test or an HbA1c test may be used to diagnose type 2 diabetes or prediabetes.

The following results indicate the presence of prediabetes:

  • Fasting plasma glucose: 6.0 mmol/L to 6.9 mmol/L
  • HbA1c: 42 to 47 mmol/mol (6.0 to 6.4%)
diabetes
http://www.diabetes.co.uk/pre-diabetes.html

Is there a cure for Pre-diabetes?

The good news is that cases of pre-diabetes that are identified early on can be reversed, preventing them from progressing into full-blown type 2 diabetes.

There are no medications which can treat or cure pre-diabetes. The only way of reducing your risk of diabetes is through lifestyle changes. This includes:

  • increasing activity levels,
  • eating a healthy and balanced diet
  • maintaining a healthy weight.

If you would like support please make an appointment with our Nurse or Healthcare assistant for a review. Also visit One You Hounslow who can help you eat well, move more, stop smoking or drink less. 

New Move Away from Pre-Diabetes Programme

People with pre-diabetes will often have no symptoms, but have an increased risk of diabetes and heart disease. Patients belonging to Feltham and Great West Road Localities can access a special service and reduce the risk of developing diabetes.

What is Pre-diabetes?

Pre-diabetes is also called Impaired Glucose Tolerance. Like diabetes, pre-diabetes is a condition where the amount of glucose (sugar) in the blood is too high and the body cannot use it properly. The glucose levels are not high enough at this stage to be diagnosed with diabetes.

In pre-diabetes, the pancreas (an organ in the body) does not produce enough insulin or the insulin that is produced doesn’t work properly. Insulin is a hormone in the blood which lowers and controls blood glucose level. This is often the result of carrying extra fat around the waist area.

Is there a cure for Pre-diabetes?

There are no medications which can treat or cure pre-diabetes.

The only way of reducing your risk of diabetes is through lifestyle changes. This includes increasing activity levels, eating a healthy, balanced diet & maintaining a healthy weight.

What is the ‘Move Away from Pre-diabetes’ programme?

The programme is fun, motivating and an excellent opportunity for you to learn more about nutrition and making healthy changes to your lifestyle.

The service aims to help you achieve:

  • healthy weight
  • healthy eating
  • more active lifestyle
  • improved blood pressure, blood glucose & cholesterol

You can download the patient leaflet here.

MAP Patient leaflet (hounslow)

MAP

People with diabetes are being fined up to £100 for claiming free prescriptions without a medical exemption certificate.

People with diabetes are being fined up to £100 for claiming free prescriptions without a medical exemption certificate. We need your help to stop this.  

 Everyone in England who uses insulin or takes medication to manage their diabetes is able to claim free prescriptions but they must have a valid medical exemption certificate to do so. This certificate must be renewed every five years.

 The NHS Business Services Authority, have recently introduced a far more rigorous checking system than in the past. The poor management and lack of enforcement of the certificates over a long period of time has led to the understandable misconception, from patients and professionals alike, that anyone with diabetes who uses medication or insulin is automatically exempt from prescription charges.

 This is not the case. Everybody must have a valid medical exemption certificate and renew this every five years.

 We want to make sure people with diabetes and healthcare professionals know this. On our website we have information for people with diabetes, explaining how to get the certificate and what to do if they have received a fine: www.diabetes.org.uk/claiming-free-prescriptions

 We also have information for healthcare professionals, to explain their role in making sure people have the right information and avoid being fined:

http://www.diabetes.org.uk/Professionals/News–updates/People-with-diabetes-are-being-fined-for-claiming-free-prescriptions/

Prescription

New Diabetic Service for Hounslow.

Here are the slides to go with Dr Delgado’s presentation to the Great West Road Locality.

Locality presentation Diabetes ii

Here is a link to a previous article which summarises the service. 

If you would like to attend training, here are the details for the course. MERIT Hounslow

New Diabetic Service - Pic

 

New Diabetic Service for Hounslow CCG

Dr Delgado Raquel, diabetic lead for Hounslow CCG presented to new diabetic service commissioned and it’s impact on the locality. DM

3 types of services will be commissioned for practices. This can be delivered either by the practice or locality level. If necessary, neighboring localities can provide services. There may be flexible delivery of service, where resources within the locality. Eg delivery of level 2 requires 2 clinicians, and premises. If one practice cannot deliver this, we may be able to clinicians from 2 practices and run the service from where there is clinical space available. We will also be supported to explore new ways provide consultations eg email, phone and online. The key outcomes are improved diabetic care, identifying diabetic care, improving access and upskilling primary care and patients.

3 types of service will be commissioned.

  • High risk of diabetes
  • Level 1 – managing type 2 diabetics
  • Level 2 – Initiating insulin.

Key Outcomes

  • Address variation of care across CCG and practices.
  • Early identification and prevention. Reduces the consequent complications.
  • Better management of 9 care processes,
  • NWL diabetes education programme
  • Diabetes dashboard, will be available which allows comparing across practice, locality, CCG and NWL.
  • New diabetes community service.
  • Systm One OOH templates (yellow means that you have to input data).
  • Local diabetes education courses for clinicians. Doctors and nurses. These will be available, more information will be available shortly.

High Risk

  • Register, XaZLG code. Gestational diabetes and abnormal glucose test.
  • Annual BP, HbA1c, Lipids, smoking, BMI, Lifesytle intervention / referral.
  • High risk

Level 1 diabetes.

  • Refer to structured education programme
  • Annual 9 care processes including ACR and retinal screening (which are not included in QoF)
  • Annual review with 30m appointment.
  • Hypoglycaemia recording frequency and management.
  • Following CCWHE guidelines Diabetes for BP, Lipids, HbA1c insulin and glucose strips.
  • Care planning including housebound patients.
  • Copy of care plan given to patient.
  • Patient satisfaction survey.
  • Discharge from secondary care suitable patients.

Level 2

  • Insulin and GLP-1 Initiation and optimization and insulin education.
  • Need to have 2 accredited clinicians.
  • Annual accredited re-fresher course.
  • Adhere to prescribing guidelines.
  • Face to face appointments, telephone, email.
  • Dietician and DSN from the community service.
  • Referral to insulin education programme.
  • Min network population of 30,000.
  • Can have up to 3 sites for a locality.
  • Patient will be seen 11 times.

New diabetic service will have:

  • New diabetic service has dieticians, DSN, podiatrist, clinical psychologist linked to each locality.
  • It will be a flexible service.
  • Email and telephone access to all clinicians.
  • Joint clinics with diabetologist, Diabetic specialist nurse and dieticians.
  • Joint visits for housebound patients.
  • Larger choice of education programmes for patients and clinicians.

Self Referral

connection

Self Referral

There are a number of clinics, where you care refer yourself. Details are outlined in the leaflets below.

Autism Self Referral

Childrens Centre

Expert Patient Self Referral

You can refer yourself to a self management programme, which is free of charge.

 Click here for the self referral form.Expert Patient (1)

Holding Off Diabetes

If you are at high risk of diabetes, eg strong family history or have impaired fasting glucose, you can self refer using the form below.

Holding Off Diabetes
You can self refer if you have high risk of developing diabetes.
Click here for the form – Holding off Diabetes – website
Download
Carers Self Referral Form
Advice and support is available for you, if you care for someone with a long term condition or disability who has care needs. You may complete this form for an assessment to be carried out.
Click here for the self referral form. carers_assessment_referral_form