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Diabetes |
Diabetes Clinic
The GMC has introduced a monthly diabetes clinic, where diabetes patients are invited to come in to the centre to have a review with practice nurse Jenny Gowan.
The clinic is based on the Merck Sharpe and Dohme heartbete program, which allows us to more easily manage our diabetic patients and includes patient education material.
First of all we write to our diabetic patients to invite them in for a review. During the review, we go through the various parameters that are believed to be best for optimal diabetes care.
The patient will have a urine test and blood pressure check during the clinic, and blood tests if needed. They will also receive education material and be able to speak to Jenny about various issues related to their diabetes. They will then be asked to return for review by their GP.
The current best practice guidelines recommend that diabetics have the following checked on a regular basis:
1. Weight 3 to 4 times per year.
2. Blood pressure at every visit or 4 times per year.
3. Eye check every 1 to 2 years (prevention of diabetic retinopathy).
4. Foot check - pain, footwear, general appearance, pulses, sensation every 6 months (prevention of diabetic foot disease).
5. Cholesterol check every 1 to 2 years. More frequently if abnormal.
6. HbA1c blood test. Every 3 - 6 months if treated with insulin otherwise every 6-12 months.
7. Check for albumin in the urine yearly (prevention of diabetic nephropathy).
Diabetic patients in the practice are encouraged to contact their doctors if they are unsure if these tests have been done or what their results are.
We encourage you to come along to one of the diabetes clinics.
Diabetes and diet - what do you believe?
Many people with diabetes are confused as to what they should eat without affecting their blood sugar levels. You may be receiving conflicting information from all sorts of sources. Is sugar really that bad? Does the fat in your diet affect your diabetes? Should you avoid fruit?
Current recommendations for a healthy diet are simple. Eat a wide variety of foods, minimise fat, choose plenty of carbohydrates and fibre, and take regular exercise.
Cutting down the fat
Too much fat in food causes obesity and can cause high blood cholesterol, which clogs up blood vessels. Being overweight can also worsen blood sugar control.
Cutting down the fat means reducing the amounts of butter, margarine, oil, salad dressings and fatty meat you eat. It also means watching the hidden fats in cakes, chocolates, and pastries.
Carbohydrate - the energy food
Carbohydrate is an energy nutrient found in the blood stream as sugar (glucose). Your body relies on carbohydrates for fuel. Filling up on carbohydrates provides your body with energy without the fat. This includes breads and cereals, fruit, ‘starchy’ vegetables like potato, corn and alternatives such as pasta.
Some carbohydrates turn to blood sugar slowly, some quickly and some in between. The slwo carbohydrates have a low impact on blood sugar and so are the best choices. For example, multigrain bread is slower than white bread; apples are slower than bananas.
A dietician can give you more information on the best choices.
What about sugar?
Some good news from recent research suggests that not all sugars need be completely forbidden. However, people with diabetes should aim to have only small amounts. Use sweet foods with other nutritious foods. For example jam on multigrain bread, or a small amount of sugar or honey on cereal is acceptable, but sweet soft drinks and highly sweetened desserts are not good choices.
If you have diabetes and want to be updated about dietary management, see our dietician here at the GMC.
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