The Derby Medical Centre, 8 The Derby Square, Epsom, Surrey, KT19 8AG

Telephone: 01372 726361

Diabetes Mellitus

We run a diabetic service for our patients. Your care will be by your own registered doctor along with our trained nurses.

Your care will include an annual diabetes check and a 6 monthly review if your condition is well controlled and stable. There may be times when you are seen more frequently to optimize your control and when your treatment is being changed or altered.

The Annual Diabetes Check

This will include a discussion about your diabetes and its treatment, test and measurements will be covered each year and sometimes more frequently. Some of these tests are to identify risk factors which can be altered to prevent you developing complications of diabetes.

What to Expect

Examination

Blood Pressure: this is a risk factor for heart disease, stroke and kidney damage. The target blood pressure is 140/80 or 135/75 if kidney damage is present. The best rule to follow is the lower the better.

Body Mass Index(BMI) :This is the ratio between your height and weight

Target :
20-25 best weight
Above 25 overweight
Above 30 obese

Feet: Your feet will be checked once a year for circulation and sensation. This is to detect early signs of peripheral vascular disease and neuropathy. Detection and treatment can prevent complications such as gangrene and ulcers.

Retinal Screening: You will have an annual appointment at the Diabetic Retinopathy Screening Service for Surrey unless you already see an ophthalmologist regularly. At this appointment the back of the eye (the retina) is checked for early diabetic changes which could result in blindness if left untreated. If you already attend an eye clinic for another reason your check will be done there.

Waist Circumference: Increased amounts of fat around your abdomen will affect your body’s ability to use insulin-this is called insulin resistance. Reducing this will improve your health and improve your blood glucose control.

Blood Tests

HbA1c :This is a measure of your long term blood glucose control and reflects the last 3 months. The lower the value the better and the aim is for this to be under 6.5%. Reducing to this value will reduce the risk of complications to your eyes, feet, kidneys and nerves.

Glomerular Filtration Rate (GFR): This is a measure of kidney function. Persistent readings under 60ml/min are classified as Chronic Kidney Disease.

Lipids/Cholesterol/Triglycerides: This is measure of your body’s blood fats. You should aim to have your total cholesterol under 4 and your LDL (bad cholesterol )below 3

Liver Function Test: This is monitored as part if the surveillance of lipid modification and other diabetic drugs.

Urine Test

Urinalysis: this detects protein in your urine and is an indicator of damage to the kidney

Albumin:creatinine ratio (ACR): This detects and measures microalbuminuria and indicates that good control of your diabetes, blood pressure and cholesterol is needed.

Other issues

Depression: you will be asked some screening questions and help and support is available if needed.

DVLA: Driving and when and if to inform the DVLA will be discussed.

Erectile Problems: This is a common problems and advice and treatment is available

Smoking: We have a smoking cessation advice service and an appointment for this can be booked at reception.

Prescription Exemption: If you take medicines to help control your blood glucose level you are eligible for free prescriptions. Ask for a form at reception.

Vaccinations: It is important that you have a pneumococcal vaccination and an annual flu vaccination as these infections can be serious if you have diabetes.

Dietician

We have a dietician who runs a clinic once every 2 weeks at the Derby Medical Centre. All new diabetic patients will be seen in this clinic

Chiropody

You should have a foot check once a year and we have a chiropody service in the Derby Medical centre once ever 2 weeks. Please ask at reception for an appointment.

Foot Emergencies

If you are concerned that you may have an infection in your foot, a new ulcer, sudden onset of pain and swelling in the foot or discolouration please speak to your GP ASAP.

There is an emergency Community Foot Clinic at Leatherhead Hospital on Fridays at 1/30-4pm Sharps Disposal

If you are on an injectable form of treatment for your diabetes you will be prescribed a sharps bin for the safe disposal of needles.

Epsom and Ewell Borough Council offer one free collection per year per patient. Please telephone the council on 01372732000

Further Information

Diabetes Uk is a good source of information and access to their website is free.
Diabetes Practice Leaflet
Patient Uk website www.patient.co.uk