Referrals for Diabetes Specialist Nurse Clinic

Use the Community Health Service form (RP)

Appropriate reasons for referral include:

1. Adults with Type 1 diabetes mellitus – if not already under consultant care please also refer to consultant using e-referral

2. Patients recently discharged from hospital who have been started on insulin therapy.

3. Patients who have recently been admitted to hospital due to hypoglycaemia, Diabetic Ketoacidosis (DKA) or Hyperosmolar Hyperglycaemic State (HHS).

4. Patients on insulin therapy insulin therapy experiencing hypoglycaemia or symptomatic hyperglycaemia.

5. Adults with Type 2 diabetes mellitus with HbA₁c >75mmol/mol OR HbA₁c significantly above target; for example, younger patients (<40 years) with shorter duration of diabetes (<10 years) AND on maximum tolerated oral therapy for consideration of insulin or GLP-1 therapy OR on insulin or GLP-1 therapy requiring further optimisation of glycaemic control

6. Women with diabetes on agents other than Metformin who are planning pregnancy and require optimisation of blood glucose control – please also refer to the Diabetes Consultant using e-referral

Exclusions

1. Patients with newly diagnosed Type 2 diabetes should be referred for structured education.

2. Patients with Type 2 diabetes not on maximum tolerated therapy.

3. Patients in whom a new diagnosis of Type 1 diabetes is being considered or if the diagnosis of type of diabetes is not clear– contact the Specialist Registrar via Royal London Hospital Switchboard bleep 1585.

4. Diabetes in pregnancy – refer to the antenatal diabetes clinic.

5. Referrals to Diabetes Consultants should be made using the e-referral system

Standard Referral Letter to Diabetes Service (1)

Community Diabetes Specialist Nurse Referral Criteria