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Diabetes annual review

The aim of this resource is to give you more information about the annual review. Feel free to ask questions if there is anything you do not understand.

It is normal to feel anxious about information such as this. We hope it will help you understand your diabetes better but please come and talk to us about your worries.

Why do I need an annual review?

All people with Diabetes (Type 1 and Type 2) who are over the age of 10 and who have had diabetes for more than 3 years should have a number of health checks very year.

Diabetes can cause damage to the blood vessels in the body. These include the tiny ones on the eyes, nerves and kidneys and also to the larger blood vessels in the legs, heart and so on.

The higher the blood sugar levels (and HbA1c test), the greater the risk of developing complications. You can reduce your chances of problems by trying to keep your HbA1c result below 48mmol/mol.

Smoking increases your chance of complications, so it is better not to start.

Even if your control is good it is important to have this annual review to make sure everything is still okay, or to pick up any problems as soon as possible.

What will be checked?

Eyes

We can check the back of your eye (your retina) in clinic but a better way is to have a retinal photograph taken by one of the approved Opticians in Sheffield. These photos get checked by Eye Specialists at the Northern General Hospital who will pick out any early problems, such as these pale areas or areas of small bleeding.

If it gets more severe, tiny extra small blood vessels develop in the retina which can start to affect vision. If picked up early (by eye screening) they can be treated with laser treatment.

Photograph of nerves and vessels in an eye

Register for eye screening at clinic or with your GP. Report any problems with your vision straight away.

To register for eye screening you need to sign a form, either in clinic or at your GP. You will be sent a list of registered Opticians who have the special retinal cameras. Just going to any optician will not give you the full check up.

Aim for an HbA1c of less than 7.5 percent.

Kidneys

A urine sample

You will need to give a urine sample, ideally one collected first thing in morning which will be checked for a protein called albumin. If there is early damage to the kidney it starts to leak extra albumen into the urine. You may be asked for a few samples.

Blood pressure

If the blood pressure check in clinic is high we may ask you to have a more detailed check which measures your blood pressure every few minutes at home for 24 hours whilst you carry on with your normal life.

Nerves

Please tell us if you have any problems with tingling or numbness. Nerve problems to the gut can cause nausea, vomiting or diarrhoea. If these symptoms persist, then please let us know.

Checking for other autoimmune diseases

Diabetes is an autoimmune disease caused by your body producing antibodies against the cells in the pancreas gland which make insulin. When you have one autoimmune disease the chances of getting other ones is increased.

The common problems that can occur with diabetes are with the thyroid gland (either over or under active) or with the gut called Coeliac disease.

We can check for these with blood tests.

Checking for other problems

If you have Type 2 Diabetes we will also need to check your blood lipid (fat) levels and your liver function. This is also done at the same once a year blood test.

What if there are problems?

It is always better if we can pick up complications at an early stage. There is a lot of treatment available.

If you have eye problems then you might be referred up to an eye specialist at the Hallamshire Hospital. Laser treatment may be needed.

If you have problems with your kidneys, some medicines can be used which reduce the leak of albumen in the urine and help control blood pressure levels. The most commonly used drugs are called ACE inhibitors. They should not be used during pregnancy so please let us know if there is any chance.

If you have any problems with your nerves then we may ask for more detailed nerve tests. Various medicines can be used to treat symptoms. This is uncommon in young children.

If you have a thyroid disease then this can usually treated with medicine.

If you may have Coeliac disease, then we will need to do a bowel biopsy. Coeliac disease is treated with a special diet.

Remember

Good blood sugar control reduces the risk of complications. Your annual review should include:

  • Eye screening by an optician
  • Urine sample check
  • Blood pressure check
  • Blood samples

Let us know if you have not had this done this year.

Is something missing from this resource that you think should be included? Please let us know

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Disclaimer

Please note this is a generic information sheet relating to care at Sheffield Children’s. The details in this resource may not necessarily reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If you have specific questions about how this resource relates to your child, please ask your doctor.

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NHS

Western Bank
Sheffield
S10 2TH

United Kingdom

Switchboard: 0114 271 7000

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