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Asthma Annual Cycle of Care

Diabetes Annual Cycle of Care

As a Diabetic, it is important that you have regular check-ups with your GP.  We ask all diabetic patient to attend regular appointments. This allows your GP to help you manage your Diabetes and reduce your risk of diabetes related complications that can affect your whole body including eyes, feet, kidneys, nerves and heart.

Once a year we complete what is called a Diabetes Cycle of Care (DACC). This DACC involves monitoring of all of the below.

HbA1c- this blood test enables us to monitor how well you are controlling your blood sugar levels of the last 10-12 weeks. It should be done at least every 6 month and more regularly if your blood sugars are consistently high. The HbA1c ideally should be 7% (53mmol/mol) or less.

All diabetics should be monitoring their own blood sugar levels at home at an frequency agreed suitable by you and your GP.

Blood tests

Kidney function and other tests

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Annual cycle of care

If your blood pressure and blood sugar levels remain high, there is an increased risk of damage to your kidneys (Diabetic Nephropathy). We monitor your kidney health with an annual blood and urine test.

At the same time as your kidney function, we also check your Liver function, cholesterol, iron and Full blood picture with a simple blood test. Keeping these results in the normal range significantly reduces your risk of developing complications from Diabetes.

Eye examination

It is important that you regularly have your eyes checked. This is because one of the common complications of diabetes is damage to the small blood vessels at the back of your eyes. This can occur without you being aware. If not identified and treated early, can lead to blindness. It is recommended that your GP check your eyes annually as part of your Diabetes cycle of care and you routinely have a full eye check up with an optometrist or Ophthalmologist every two years.

Foot examination

Looking after your feet is very important when you have diabetes. Diabetics are at risk of loss sensation in their feet leaving them unable to know when feet have been injured and poor blood supply.  Your feet should be examined every day for cuts and scratches. Regular appointments with a podiatrist is recommended. The GP or practice nurse will perform a thorough examination of your feet at least annually or more frequently if there are any problems. You should report to your GP any numbness, discolouration of skin, cramps, non-healing wounds. Failure to promptly treat any problems with your feet can could result in chronic ulcers and amputation.

General health

Aim to do at least 30 mins of physical activity 4-5 times a week. This activity can be anything that increases your heart rate and should be something you enjoy.

Quitting smoking significantly reduces the risk of diabetes related complications. If you are wanting to quit but finding it difficult, talk to your GP.

A healthy diet will help you achieve stable blood sugar control reducing your risk of complications. If you are having difficulty with this or would like more information we are able to refer you to see a dietitian or diabetes educator. You may be eligible to obtain this assistance free of charge through Diabetes WA or a chronic disease management plan.


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