This is your clinic. You and your family will come to the clinic about four times each year. The regular checks given at the clinic are important to ensure your diabetes is well managed now and in the future.
There will be plenty of time to discuss your diabetes, as you will have the opportunity to talk to the dietitian, doctor and nurses. Each time you come to the clinic you will be weighed, your height will be measured and a blood test called the HbA1c or the glycosylated haemoglobin will be taken. This test tells the average blood glucose level for the 2-3 months before the clinic visit.
You will learn more about the importance of the HbA1c and its effect on growth, development and long-term health from your diabetes team.
HbA1c/glycosylated haemoglobin level
The normal reference range for an HbA1c value is 4-6%, although this may vary very slightly from hospital to hospital. This laboratory test provides an accurate indication of patients’ overall blood glucose control during the 2-3 months before the blood sample is taken. In simple terms, the test assesses how much glucose is fixed to the red blood cells.
If diabetes control has been poor (frequent and persistent high blood sugar levels), a large amount of glucose will be fixed to the red blood cells which will give rise to a high HbA1c. If, on the other hand, diabetes control has been good (relatively normal blood sugar levels), there will be less glucose fixed to the red blood cells and the HbA1c will be closer to the normal range.
Recent government guidelines; National Institute for Clinical Excellence [NICE] 2004, recommend an HbA1c of 7.5% or less for children and young people with diabetes. This is mainly because the Diabetes Control and Complications Trial (1993) highlighted the importance of good diabetes control to reduce the risk of developing the serious diabetes related complications.
Your diabetes specialist nurse can give examples of how daily blood glucose (sugar) values compare to the HbA1c value.
You may see a dentist and an ophthalmologist (eye specialist) while you are in hospital. After this, your eyes will be checked each year in the clinic but you should also visit your own optician and dentist annually. From the age of 12 years, you should be referred for annual retinal photography (a painless procedure for taking a picture of the inside of your eyes), as part of your diabetes annual review.
Each year you will have an ANNUAL REVIEW, a yearly assessment by the diabetes team. At your annual review you will have a ‘head to toe’ assessment.
During at least one of your visits to the clinic each year you may have the chance to meet other children of around your age who also have diabetes, and you will take part in some activities and games.
Sometimes there will be activities and holidays organised for you. Apart from having fun and meeting others with diabetes, the aim is to help you learn to look after your diabetes yourself, so that you can enjoy trips away from home such as with your school, Scouts, or Guides. Your diabetes team are always open to new ideas so if you can think of anything you would like to do, then let them know.
The aim of the Annual Review is to ensure that the diabetes is not causing any additional health problems. Your child will usually have a blood test to check for cholesterol levels, thyroid function and to look for signs of coeliac disease. Your child’s urine will be checked for micro-albuminuria to check kidney function. Feet will also be checked and your child will be referred to a podiatrist if any foot problems are discovered.
Members of the diabetes team:
You can collect some supplies of the equipment you need from the clinic, although most items are now available through your family doctor.
Available from hospital clinic/chemist:
Available from GP: