London Diabetes Centre protocol

Height, Weight, Blood Pressure

Glycated haemoglobin is an analysis of your blood taken via finger prick. This measurement gives us information about your average blood sugar values in the past 8-12 weeks.

A random blood glucose test measures the amount of a sugar called glucose in a sample of your blood that is taken via finger prick.

This is a urine test which measures albumin leakage in the urine, a sensitive test for early kidney involvement in diabetes.

• Full Blood Count, this is a test to check the types and numbers of cells in your blood, including red blood cells, white blood cells and platelets. This can help give an indication of your general health, as well as provide important indications about any underlying health problems you may have.
• ESR, or erythrocyte sedimentation rate (ESR), is a blood test that can reveal inflammatory activity in your body. It can help your doctor diagnose or monitor the progress of an inflammatory disease.
• Fasting Lipids, this calculates the amount of bad cholesterol, called the LDL cholesterol or low density cholesterol, the good HDL or high density cholesterol and the triglyceride. It is the most common way of making an assessment of the risk for stroke and heart attached in people with diabetes.
• Full Biochemistry, this metabolic panel measures sodium, potassium, chloride, bicarbonate, blood urea nitrogen (BUN), magnesium, iron, creatinine, glucose, and calcium.
• Vitamin D2 and D3, Vitamin D is essential for bones, for cardiovascular health and as a protection for statin side effects. This test measures the level of vitamin D in the blood.
• Fasting Insulin or c peptide, gives your doctor a measure of your sensitivity to insulin and whether you are deficient in this essential hormone. Sequential results are very useful.
• PSA (if male > 55yrs), the PSA test is one of the blood tests to screen for prostate enlargement or prostate cancer.
• Ferritin, high levels of ferritin can indicate an iron storage disorder, such as hemochromatosis, or a chronic disease process. Low levels of ferritin are indicative of iron deficiency, which causes anaemia.

Carotid intima–media thickness and 3D plaque information can aid prediction of coronary heart disease and stroke risk when added to traditional risk factors. Our latest 3D probe, the first in Europe, enables us to now obtain volume quantification of plaque enlargement. Done regularly every two years, the test enables the doctor to assess adequacy of treatment and progression or regression of arterial thickening. The test is safe and painless and involves no radiation as it is done with an ultrasound machine.

Diabetes can affect your eyes in a number of ways. The most serious eye condition related to diabetes is diabetic retinopathy. Early diagnosis is vital.

Visual Acuity - A visual acuity test is an eye exam that checks how well you see the details of a letter or symbol from a specific distance.

Intraocular pressure - Intraocular pressure (IOP) is the fluid pressure inside the eye. Tonometry is the method eye care professionals use to determine this. IOP is an important aspect in the evaluation of patients at risk of glaucoma.

Fundus Photograph - Fundus photography is used to inspect anomalies associated to diseases that affect the eye and to monitor the progression of the disease. It is vital for disease processes such as macular degeneration, retinal neoplasms, choroid disturbances and diabetic retinopathy.

Glycated haemoglobin is an analysis of your Diabetes can reduce the blood supply to your feet and cause a loss of feeling known as peripheral neuropathy. This can mean foot injuries don't heal well and you may not notice if your foot is sore or injured.

Quantitative vibrametry and thermal tests - Establishing nerve damage and arterial insufficiency are key assessments. The traditional tuning fork approach is crude and imprecise and only measures the large myelinated nerve fibres. Warm thermal thresholds give information on the important small unmyelinated C fibres and cold thresholds test the alpha delta nerve fibres. The London Diabetes Centre is the first clinic to include quantitative vibrametry and thermal tests on the feet. Your results can now be measured and improvement and deterioration followed quantitatively every year.ood taken via finger prick. This measurement gives us information about your average blood sugar values in the past 8-12 weeks.

Any CGM device, or insulin pump.

45 Minute consultation with a specialist consultant with review of relevant medical results you should bring with you to the appointment.

60 minute dietitian or diabetes specialist nurse consultation.

Written report from consultant.

Any prescriptions advised by the consultant are available from our in house pharmacy; as medication requirements vary from person to person any costs for medications are not included in this package.