Diabetes-Referral guide

Manage in primary care -Impaired GTT Impaired fasting glucose New diagnosis type 2 diabetes Minor self-treated hypoglycaemia Transient hyperglycaemia Well controlled diabetes ( diet or treated ) Stable micro-macro vascular complications

Referral to secondary care - Routine All with type 1 diabetes - managed in secondary care Age < 25 yrs Patient not achieving target HbA1c despite optimum management in general practice orWorsening glycaemic control Erratic glycemic control Assessment for insulin initiation or intensification / change GLP-1 - assessment and initiation Patient on GLP-1 and considering GLP-1 initiation Considering or already on insulin pump Blood pressure - uncontrolled despite optimum management as per NICE guideline Diabetes complications asNeuropathy - GI tract , hypotension , erectile dysfunctionDiabetes arthritis e.g carpal tunnel syndromeIsolated nerve palsy e.g 3rd N , foot dropProgressive mico-macro vascular complications despite max RxRetinopathy requiring laser treatment or grade >= 3 PCOS ( with or without diabetes ) Obesity management e.g bariatric surgery Secondary diabetes e.g○ steroid use○ acromegaly○ psychoses treatment○ pancreatitis Complex medical co-morbidities

Referral- Urgent- Hyperglycaemia and symptomatic Suspected ketoacidosis or non-ketotic hyperosmolar coma Severe hypoglycaemiaepisode requiring 3rd party assistance or Health care professional help Children with newly diagnosis or suspected diabetes New diagnosis of Type-1 diabetes...