The diabetes annual cycle of care is a checklist for reviewing your diabetes management and general health – if you have diabetes it is recommended that you do this review with your general practitioner (GP) each year. As part of this process, your GP may refer you to other health professionals, such as a dietitian, diabetes educator, podiatrist, ophthalmologist, exercise physiologist or endocrinologist, to help you in managing your diabetes and reducing the risk of complications.
The health checks included in the cycle of care include:
- HbA1c: a blood test to measure your average blood glucose levels over the past 2-3 months. Persistent high blood glucose levels can lead to diabetes-related complications such as heart, eye, kidney and nerve damage. Keeping blood glucose levels in your target range can help to reduce the risk of developing these complications.
- Blood pressure: is a measure of the force of circulating blood on the walls of your blood vessels. High blood pressure increases the risk of heart disease, stroke, eye damage and kidney damage. This means that managing blood pressure is just as important as managing blood glucose levels when it comes to preventing diabetes-related complications.
- Foot checks: An initial foot check should be done by your doctor, diabetes educator, practice nurse or podiatrist. If your feet are found to be low risk, then it is recommended that you have an annual foot check. If assessed as high or intermediate risk then you will need more regular checks – at least every 3-6 months, or more often if needed.
- Eye checks: Visit an ophthalmologist or optometrist once a year to check your eyes through dilated pupils. This is needed to check for diabetic eye damage (retinopathy), as well as cataracts, glaucoma and other eye disorders that occur more frequently in people with diabetes. If any problems are detected, you may need more regular visits.
- Kidney health: An annual urine test, the urinary albumin to creatinine ratio (UACR), shows whether small amounts of protein are passing into the urine can indicate very early signs of kidney damage. At this stage treatment can often slow or prevent further damage. A blood test to check kidney function, called estimated glomerula filtration rate (eGFR) is also recommended.
- Blood fats: a blood test to measure the different types of fats in your blood including LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides (TG). As with high blood pressure, high blood fats can increase the risk of heart disease, stroke and other diabetes-related complications.
- Weight, waist measurement and body mass index (BMI): Carrying extra weight, especially around the middle, can make it harder to manage your blood glucose levels, blood pressure and blood fats, so it is important to keep a check on these.
During the review your GP should also ask about your lifestyle habits (such as diet, activity levels, smoking and alcohol intake), medications and emotional health.
For details of how often to have these checks and recommended targets, download a copy of the NDSS Annual Cycle of Care Fact Sheet
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