Preparing for the diabetes clinic: getting the most out of your appointment
There are potentially many issues to discuss within a limited 15 minute appointment time. In order to get the most out of your appointment we would generally recommend providing as much information as possible.
If you use insulin we will typically ask you to complete a 2 page questionnaire in advance of your appointment. By collecting this basic information (including doses, injection sites, low blood sugars (hypoglycaemia) and driving), your doctor should have more time to focus upon your concerns and any problem areas they may have identified.
Home blood glucose measurements
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If you use insulin we would ask you to bring your blood glucose meter with you (if you use several meters, please bring them all) as we can download the stored information and present your blood glucose results on the clinic computer. This can be hugely helpful in identifying patterns and providing advice on adjusting insulin doses. Some examples of this are provided below:
If you record your blood glucose results in a diary, we would encourage you to share this information with the clinic doctor.
If you usually check your blood glucose less often than has been recommended (or do not check at all) we would suggest that, for a couple of weeks leading up to your appointment, you start checking regularly. It is almost impossible to offer sensible advice about insulin dose adjustment without seeing some glucose results. Patients are often concerned or embarrassed about their results and either stop checking or do not wish to bring them to the clinic - this is often where patients have most to gain from bringing results along. The purpose of the clinic is to help, not to judge, in these situations.
It is unfortunately still not uncommon to hear patients say they "thought they would get a row" about blood glucose results which are higher than ideal. In reality, nobody offering diabetes care in the Royal Infirmary of Edinburgh would approach a problem in this manner. The role of the clinic is to support and advise, not to chastise. All patients are treated in a respectful and supportive manner.
'Intensive' blood glucose monitoring
Patients on multiple daily injections or insulin pumps may benefit from a short spell (around a week) of 'intensive glucose monitoring' in advance of clinic appointments. Performing extra checks, recording these and sharing the information prior to attending the clinic may help customise your clinic appointment towards dealing effectively with key issues. Further information on 'intensive glucose monitoring' can be found by following this link:
It is useful to bring a list of all the medication (including doses) you are currently taking along to the clinic.
Some patients use home blood pressure monitoring devices. If you have access to a home blood pressure monitor, it is useful to perform both morning and evening measurements for a few days leading up to your appointment. The information provided from a set of home recordings is typically much more valuable than a single measurement taken in clinic.
The British Hypertension Society has published a list of approved home blood pressure devices, the cheapest of which is £20.
In summary, the more information you are able to share with the clinic doctor, the more fruitful your consultation is likely to be. We recognise that many patients find it difficult to monitor their blood glucose as often as may have been recommended but we would be keen that a set of checks are performed in the days or weeks leading up to clinic; this will help ensure that your diabetes clinic appointment is a useful experience.