SOUTH SEFTON DIABETES GROUP

Annual Review

Your annual review is probably the most important part of your diabetes care. It is a way of keeping a regular check on your condition. Your healthcare team will want to see you for a number of reasons, including:

• To see how well your diabetes is being controlled
• To see how well you are coping with your diabetes
• To check on the development of any complications
• To make any necessary changes to your treatment
• To continue with your ongoing education

It is vital that attend your annual review every year. You may be taking good care of yourself and your diabetes - but it is easy to be lulled into a false sense of security.

The long-term complications of diabetes develop slowly and do not have any obvious symptoms in their early stages. However, the checks at your annual review will pick up any early signs of complications. Early detection means early treatment and early treatment will minimise the damage. There are many successful ways of treating complications, but the key to successful treatment is identifying them early.

By visiting your diabetes clinic regularly, either at the hospital or at your local surgery, you can help to protect yourself from potentially damaging complications.

What happens at the annual review?

• Your general health should be reviewed
• Your weight (and height, if you are still growing) should be recorded
• Your should provide a urine sample for protein measurement
• Your blood should be tested to measure long term control (HbAlc). This may be done one or two weeks prior to the rest of your annual review
• Your blood pressure should be checked
• Your vision should be checked
• The back of your eyes should be examined
• Your legs and feet should be examined to check your skin, circulation and nerve supply. If necessary you should be referred to a state registered podiatrist (chiropodist)
• If you use insulin, your injection sites should be examined

At the end of this examination you should have the chance to discuss the results with the doctor.

You should also have the opportunity to discuss the following:

• Your general well being
• Your diabetes control, including your home monitoring results
• Your current treatment
• Any episodes of hypoglycaemia
• The results of your blood/urine tests
• How you are coping at home, work, school or college
• Any lifestyle issues, such as smoking, alcohol consumption, sexual problems, physical activity and healthy eating issues.
• Any other problems

You should feel free to raise any issues that you feel are important to you. Remember that your healthcare team are there to help you, but they can only do so if you if you let them know that you are in need of help.

Assessing risk factors

As part of your annual review your risk of developing complications will be assessed in a number of ways.

In addition to having your blood pressure checked, you will have some blood taken and sent off to the laboratory. Some of the tests may include:

• Glycated haemoglobin, or HbA1c - this gives an indication of blood glucose control
• Lipid profile - this may include tests for cholesterol and triglycerides

Checking for signs of complications

Early detection of complications is important. Your annual review should include the following checks:

• Dilated eye exam - to check for any signs of retinopathy. NOTE! This may involve putting specials drops in the eye which dilate the pupil. Your close-up vision may be blurred for a couple of hours afterwards and you will be especially sensitive to bright light. You should not drive for several hours afterwards and might benefit from wearing sunglasses.
• Kidney function tests - urine test for protein; blood test for creatinine
• Your legs and feet should be examined to check your skin, circulation and nerve supply. Changes to any of these may mean that you are at greater risk of developing foot problems

Making the most of the annual review

Clinic visits can be daunting. If you have a tendency to feel overwhelmed by the whole "clinic experience" then take a look at Talking to your Doctor, which provides some useful tips and should help you to feel more in control of the situation. Diabetes Insight has also compiled an Annual Review Checklist, which may be of use to you.

It is important to remember that the goal of your diabetes care is to allow you to lead a normal and healthy life. The annual review must meet your agenda as well as that of the healthcare team.