Diabetes type 1

What happens at the diabetes clinic?

There are certain things that you should expect from your medical team. If you have just been diagnosed with Type 1 diabetes you should have: 

  • A full medical examination- this may also include a referral to a specialist eye clinic.
  • A talk with a diabetes care nurse who will explain what diabetes is and about your treatment. 
  • Several sessions with your diabetes nurse for basic instruction on injection technique, looking after your insulin, blood glucose meter and pen, blood glucose testing and what the results of your own testing means.
  • You should also expect to have a discussion about hypoglycaemia (hypos) and how to deal with it.

After this initial help, you should have access to a diabetes care team where you will have the opportunity to talk to doctors, nurses and dieticians. They will assess your diabetes control and discuss any problems with you. You should also be given a contact number so that you are able to contact a member of the team for advice whenever you need it. Most diabetic clinics have a specialist nurse who will visit you at home between hospital appointments especially in the early days after your diagnosis. 

Each year you are entitled to an Annual Review assessment by the diabetes care team.This should include a blood pressure check, a measurement of height and weight, drawing blood to find out your cholesterol level and your HbA1c (average blood glucose over the last few weeks), plus a urine test to check whether your kidneys are working well. They should also examine your feet and reflexes to check that your nerves are okay, and they may ask you whether you smoke and offer help to give up if you would like to do so. 

In addition, the annual review should include an examination of your eyes, although this may be done at a specialist eye clinic. Drops will be put in your eyes so your pupils with get big enough for a photo to be taken (from outside your eye) of the retina at the back of your eyes. The drops will make your vision blurry and you will be sensitive to light for a few hours, so you should be careful not to arrange to drive after your eye appointment. The annual review is also an opportunity to discuss how your control of your diabetes is going and your home monitoring results.

Your clinic should keep you in touch with the latest advances in the management of diabetes and advise on patient education courses to help.

Experiences of care

Most of the young people we interviewed said that they had appointments with their diabetes care team every three or six months. One young man hasn't been seen at a diabetes clinic for almost three years. Many said that, as they learned to control their diabetes better, the nurse home visits became less frequent. Most were able to contact their specialist diabetes nurse in between appointments when they needed her/his advice. A few of the young people we talked to said that they have no access to a diabetes specialist nurse outside their visits to the diabetes clinic. One young woman was unhappy about seeing her diabetes care team only once a year. She said it was difficult to get to know her nurse because she has seen her only once in the past year and a half.
All of the young people we interviewed said that they had an annual review that included all the tests and examinations listed above. The urine test is to check for early signs of damage to the kidneys which mean that they leak small amounts of protein into the urine, but some people didn't know what the urine test was for. Some hadn't had certain tests or examinations done for some time. One young woman hadn't had an eye examination in the last three years because she felt her eyes were fine. Some people go to their GP for feet and legs examinations. All these tests and examinations help to detect early signs of complications so they can be treated and managed as soon as possible.

Note: If you want to find out more about what standards of care to expect please refer to the National Service Framework (NSF) for Diabetes produced by the Departments of Health in England, Northern Ireland, Wales and Scotland. 

Young people should be able to collect the following supplies from their clinic: finger pricking device, monitoring diary, insulin pen injector, blood glucose meter (if available). And from their GP on prescription: lancets for finger pricking devices, blood glucose test strips, strips to test urine for glucose and ketones, disposable insulin syringes, insulin, glucagon's (GlucaGen Kit), glucose gels such as Glucogel or Dextrogel, needle clipper, pen injector needles and some insulin pens.

Last reviewed December 2017.

Last updated December 2017.


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