Diabetes Department: Your Local Care

Most people with Type 1 diabetes attend a hospital diabetes clinic. People with Type 2 diabetes will mostly attend their GP, but some may need to attend the hospital diabetes clinic or both.

While attending your clinic appointment, you will be able to discuss any problems you may have with your medication and we can also provide specialist advice on diet, exercise and other lifestyle issues associated with your diabetes. You will usually be seen by a Diabetes Specialist Nurse (DSN) and in some cases you may also be seen by a Diabetologist who visits every 4 months from Glasgow. We have an excellent care link set up with Greater Glasgow & Clyde which can offer advice and support at any time via the DSNs. Young people with Diabetes have direct access to this support out with normal working hours.

If you visit one of our clinics, blood samples maybe taken and tested for:

Haemoglobin A1c (HbA1c). This is done at every visit and tells how well controlled your diabetes has been over the previous 3 months. Good control means an HbA1c of 48 – 58mmol/mol. This is equivalent to an average blood glucose of between 6 and 10 before meals. The blood sample is taken using a finger prick test. It is processed while you wait and takes about 6 minutes. This allows the Diabetes Specialist Nurse to decide if any changes to your treatment are required. All the Diebetes Specialist Nurses are able to prescribe and make any necessary changes to your medication, you do not need to see your GP as well.

Renal Function. This is checked yearly and tells us how well your kidneys are working.

Cholesterol. This tells how much ‘good fat' and ‘bad fat' is in your blood. It is checked yearly or more often if it is high.

You will also be asked to bring along a urine sample that has been collected first thing in the morning. This is tested for:

• Protein (called microalbumin). High levels of microalbumin are associated with a greater risk of developing some complications of diabetes and with high blood pressure. This can be helped with tablets called ‘ACE Inhibitors'.

At your first visit your height is measured.
At every visit your weight and blood pressure are checked.

What is diabetic retinopathy?

Picture of Diabetic Retinopathy

Diabetic Retinopathy is a condition that occurs when diabetes affects the small blood vessels in the retina, which is at the back of the eye. The blood vessels in the retina can leak or become blocked.

This condition may cause blindness or serious damage to your eyesight. In its early stages there are no symptoms so you may not realise that you have diabetic retinopathy.

Why should I be screened?

If you have diabetes then screening is important because your eyes are at risk of damage from diabetic retinopathy. Screening is a key part of your diabetes care and can reduce that risk by detecting the condition early before you notice any changes to your sight.

Untreated diabetic retinopathy is the most common cause of sight loss in people of working age. When the condition is caught early, treatment is effective at reducing or preventing damage to your sight.

Useful after-care eye drop guidance has been produced aimed at those who receive eye drops (Tropicamide 1%) during
their Diabetic Eye Screening appointment.  Click here to view.

Further information

For further information, to request an appointment or support to attend, please contact the Diabetes Centre by telephoning 01851 708327 or 01851 708331.

You can also find further information on the NHS Inform website.

Please be aware that if you have any problems or concerns related to your feet health, you can access the NHS Western Isles Podiatry Department website for further information and advice or on how to contact them.  Visit: www.wihb.scot.nhs.uk/our-services-podiatry

Holiday Foot Care

Going on holiday can cause foot problems, so follow these simple precautions to ensure a trouble-free time.

The Journey

Long journeys on trains, buses and planes can make your feet swell. Walk up and down the aisle every half hour – the exercise will help keep the swelling down. Make sure your shoes don't become too tight.

Footwear

If you normally wear hospital supplied shoes, wear them on holiday too. Remember that changing over to ordinary shoes could cause an ulcer – and ruin your holiday.

Avoid walking barefoot. On the beach, and in the sea, wear plastic sandals.

Sunburn

Avoid sunburn to your feet and legs. Use a sun screen with a high protection factor – or keep covered.

Foot Care

If your skin gets very dry in the hot weather, you may need to apply more moisturising cream than usual. Pay special attention to your heels – dry skin here cracks easily.

First Aid

Take small sterile dressings, antiseptic and adhesive tape on holiday. Clean any small blisters, cuts or grazes thoroughly then apply a sterile dressing.

Foot Check

Examine your feet daily for sores, swelling and colour changes. If any of these problems develop, then visit the local state registered podiatrist or doctor.

Remember: delays in seeking treatment may make foot problems worse. Seek early treatment for all holiday foot problems.

Foot Screening for People with Diabetes

Diabetes can have an effect on the blood and nerve supply, which can lead to complications in the leg and foot. This can slow down the healing process in the body and reduce the sensation to pain, temperature and pressure. Not everyone will develop these problems, but ALL people with diabetes should follow the same rules of foot care to prevent problems developing.

Maintaining good blood sugar and weight control is very important, as is avoiding smoking.

Your Annual Foot Check

As part of your ongoing diabetes care you will receive a formal check of your feet at least once a year. This includes checking the pulses and feeling in your feet. This will be undertaken by whoever is providing your diabetes care and may be a doctor, nurse or podiatrist. This will allow them to calculate your risk of developing a foot ulcer in the future which could be low, medium or high. You can ask your GP, nurse or podiatrist to tell you what your risk score is and they will provide you with a leaflet specially written for that risk category.

Inspect Your Feet Daily

• Look especially in between your toes and around your heels.
• If you cannot bend over, ask a friend or relative to help, or put a mirror on the ground.
• Be aware of any blisters, breaks in the skin, pain or any signs of infection such as swelling, heat or redness.

Tell your Diabetes team or Podiatrist about any changes in your feet.

Free leaflets are available to view/download from Diabetes UK.  Click here to view.