Outpatient clinics

General and specialist clinics take place daily from Monday to Friday. Phlebotomy facilities and near-patient testing for Haemoglobin A1c are available in all the clinics.

The diabetes clinical nurse specialists run a number of nurse-led clinics for the review and management of glycaemic control. In addition, they provide a wide range of specialist nurse-led services including clinics for weight management, carbohydrate counting and young adult review. Referral to nurse-led services can be made by any member of the diabetes multi-professional team or patient self-referral via the Team Administrator, if the patient has been seen in diabetes clinic within the last year.

Combined diabetes clinics are run with the renal physicians, a paediatrician from Birmingham Children’s Hospital and an obstetrician (antenatal clinic run at Birmingham Women’s Hospital).

The current clinics are as follows:

Day cases and patient education

Patients are seen for intensive education by the diabetes specialist nurses and dietitians at the Diabetes Centre (e.g. education to enable patients to commence insulin therapy, change their insulin regime, or diabetes self-care updates for patients who have developed problems with their diabetes). Education is done on an individual basis, or in groups, depending on the patient’s need.

Inpatients

The diabetes inpatient service sees patients admitted to hospital. Referrals for inpatients are made via the PICS computer system.

Dietetics and podiatry

Both dietetics and podiatry are integral to the Diabetes Service, with specialist dietitians and podiatrists based within the Diabetes Centre.

Retinal screening

There is a dedicated team of retinal screeners based within the Diabetes Centre who take eye photographs as part of routine diabetes review. These photos are then checked for diabetes-related damage, and the patient referred to the specialist ophthalmology services if appropriate.

Structured education programmes for people with diabetes

Dose Adjustment For Normal Eating (DAFNE)

DAFNE is a standardised, structured way of delivering diabetes education to people with type 1 diabetes. It focuses on self-management principles and matching insulin to food choices. It is delivered to small groups by a diabetes clinical nurse specialist, a specialist dietician and a consultant over five days. Referral is via the Diabetes Team.

More information is available on the DAFNE Web site (see "External links" below).

Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND)

DESMOND is group education for people with type 2 diabetes. It is a structured and standardised way of delivering education, in line with recommendations from the Diabetes NSF, and is delivered as either one full day or two half-day sessions by trained educators. In South Birmingham it is delivered by the Primary Diabetes Care Team with support from secondary care. Referral to the service relies on GP referral to the Diabetes Community Team Administrator based at Poplar Road Health Centre.

Continuous subcutaneous insulin infusion (CSII) service

The Diabetes Centre provides a service for people who have type 1 diabetes who control their condition with multiple daily injections. If individuals are struggling to control their diabetes or are experiencing frequent episodes of hypoglycaemia that impact on their daily life they can be considered for an insulin pump under National Institute for Clinical Excellence (NICE) guidelines. The clinic provides an opportunity for people to be reviewed and assessed with the multi-disciplinary team comprising of a diabetologist, a diabetes nurse specialist and a specialist dietitian.