Diabetes guidance 1766.pdf - East Cheshire NHS Trust
Diabetes guidance 1766.pdf - East Cheshire NHS Trust Diabetes guidance 1766.pdf - East Cheshire NHS Trust
HbA1c as a Diagnostic Test for DiabetesWhile fasting glucose is still recommended as the initial screening test for suspected diabetes, WHO (2011) hasnow recommended that HbA1c can be used as a diagnostic test for diabetes in most situations, as outlinedin the following paragraph. The main exceptions are rapid onset diabetes (as HbA1c reflects glycaemiaover the preceding 2–3 months) and some genetic, haematological and other disorders; in particularhaemoglobinopathies, anaemia and other diseases associated with changes in red cell turnover (e.g. malaria,drug-induced haemolysis) or glycation rates (e.g. chronic renal disease). In these situations, HbA1c is notrecommended as the sole test to diagnose diabetes.An HbA1c of ≥48 mmol/mol is recommended as the cut point for diagnosing diabetes.An HbA1c level ≥48 mmol/mol can therefore be used to confirm a diagnosis of diabetes in an asymptomaticindividual with a fasting glucose ≥7.0 mmol/L or random glucose ≥11.1 mmol/L, thus precluding the needfor a repeat glucose measurement or oral glucose tolerance test. However, an HbA1c value
The Newly Diagnosed Diabetic PatientDifferentiate between Type 1 and Type 2 diabetes.Features suggesting Type 1 include; Ketonuria (2+ on dipstick), Rapid weight loss, Short history of symptoms(weeks rather than months) and Age < 50 years.If Type 1 suspected consider admission or discuss with the on-call medical team / hospital diabetesteam for investigations to exclude ketoacidosis.All children aged 15mmol/L or- Patient remains symptomatic despite lifestyle changes• Advise patients that diabetes is a condition that they may need to tell theDVLA about depending on their treatment, complications and type ofdriving. Patients should check their particular situation by looking atthe DVLA website www.dvla.gov.ukPatients may need to discuss matters with their car insurer.NB. The aim is to reach targets for BP, lipids and HbA1c within 12 months for all patients.
- Page 1: Eastern CheshireVale RoyalSouth Che
- Page 5 and 6: Glycaemic ControlHbA1c MeasurementH
- Page 7 and 8: Self-Monitoring of Blood Glucose -
- Page 9 and 10: Glycaemic Control in Type 2 Diabete
- Page 11 and 12: Insulin therapy - continuedPatients
- Page 13 and 14: HypertensionBP targets are the same
- Page 15 and 16: Lipids - continuedHDL Cholesterol a
- Page 17 and 18: Screening for Diabetic NephropathyS
- Page 19 and 20: Active Foot DiseaseUlcerRefer to Sp
The Newly Diagnosed Diabetic PatientDifferentiate between Type 1 and Type 2 diabetes.Features suggesting Type 1 include; Ketonuria (2+ on dipstick), Rapid weight loss, Short history of symptoms(weeks rather than months) and Age < 50 years.If Type 1 suspected consider admission or discuss with the on-call medical team / hospital diabetesteam for investigations to exclude ketoacidosis.All children aged 15mmol/L or- Patient remains symptomatic despite lifestyle changes• Advise patients that diabetes is a condition that they may need to tell theDVLA about depending on their treatment, complications and type ofdriving. Patients should check their particular situation by looking atthe DVLA website www.dvla.gov.ukPatients may need to discuss matters with their car insurer.NB. The aim is to reach targets for BP, lipids and HbA1c within 12 months for all patients.
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