About Diabetes
The Australian Institute of Health and Welfare's report, Diabetes: Australian Facts 2008 reports that the incidence of diabetes has more than doubled in the last 15 years.
Diabetes is now one of the largest contributors to the disease burden in Australia, and type 2 diabetes accounts for 92 per cent of diabetes cases in Australia. Diabetes is associated with a number of complications, including an increased risk of developing cardiovascular, eye and kidney disease. However, type 2 diabetes is also largely preventable by controlling associated lifestyle risk factors such as overweight and obesity, physical inactivity and poor diet.
A number of studies have also shown that intensive lifestyle interventions can reduce the incidence of type 2 diabetes in people at high risk. For further information on programs for patients at risk of developing type 2 diabetes, please see Chronic Disease Prevention.
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Assessment Tools / Algorithms
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Guiding The Way - Dealing with Diabetes and Mental Health Problems September 2008
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Patient Management - Annual Cycle of Care
- Fully assess diabetic control, cardiovascular risk factors and complications.
- Review need for referral.
Medicare has introduced a Service Incentive Payment payable to general practitioners who provide the minimum annual cycle of care. This information is conveyed to Medicare Australia by use of specific item numbers.
Minimum Annual Cycle Of Care
These are minimum levels of care for all people with diabetes and obviously more care will be required for those with complications and co-risk factors.
The yearly review is a time for more detailed assessment, updating the problem priority list and re-establishment of goals, and contractual arrangements for management, eating plan, lifestyle, home monitoring and treatment need to be reviewed.
There needs to be a full system review checking for vascular, renal, eye, nerve and podiatric problems. As there is an increasing trend towards involving specialist allied health professionals, the yearly visit is a good opportunity to coordinate follow-up.
Full physical assessment:
- Cardiovascular system
- Peripheral nervous system
- Eyes
- Feet
Immunisations:
- Influenza - once per year
- Pneumococcal - once then boost as per NHMRC Guidelines
- Tetanus - booster at age 50 (unless booster has been given within 10 years).
Investigations: (annually if below target, more frequently if being actively treated)
- Lipids - triglyceride; total, HDL and LDL cholesterol
- Renal - microalbuminuria and plasma creatinine
Referral:
- Ophthalmologist / Optometrist - second yearly with no retinopathy, more frequently if abnormal.
- Dietician, Podiatrist - if patient has or has developed a problem requiring review.
- Pharmacist - for a 'Home Medications Review' if the patient is likely to have problems with medication (e.g. taking more than 5 types).
A chart to track the Diabetes Cycle of Care
Diabetes Counselling Flyer
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National Diabetes Service Scheme
Diabetes Australia has developed myD - a website specifically for people aged 16 to 25 years, living with diabetes.
Changes to Podiatry Services at FMC
Diabetes Supermarket Tours
These tours are available for people with Diabetes or those people who shop for someone with Diabetes. The tours are free and are conducted by a Dietitian from Southern Vales Community Health Service. Contact 8392 4500 for information and to book your place!
Local Council Services
For CCSM courses in your region, please click here.
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Diabetic Clinic at Noarlunga Hospital
The clinic is multidisciplinary with access to diabetes nurse education, dietetic and podiatry input where necessary. Phone 8384 9233. See the Southern Adelaide Diabetes Resource Directory of Allied Health Services for details of the following local services:
- Diabetes Nurse Educators - Public and Private
- Dietitians - Public and Private
- Podiatrists - Public and Private
- Dental Services - Public
- Aboriginal Health Services
- Chronic Disease Self Management Programs
- Activity Centres / Health and Exercise Programs
- Quit Smoking Programs
- Weight Loss Programs
Alternatives to Hospital Care Guide - A resource enabling staff to organise services to care for people safely at home.
Noarlunga Diabetic Clinic
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