Please click on the following links for more information:

• adolescent diabetes
• antenatal diabetes
• continuous blood glucose monitoring
• diabetes renal clinic 
• diabetic retinopathy
• inSight
• insulin initiation
• insulin pumps
• multidisciplinary diabetic foot clinic. 

Adolescent diabetes
These clinics are designed to help young adults, aged between 16 and 20 years, to manage their type 1 diabetes. Topics such as dieting and alcohol are discussed in a friendly, confidential environment.

Clinics are held at Wycombe hospital on the third and fourth Wednesday afternoon of the month and at Stoke Mandeville hospital on alternate Thursday afternoons. These clinics are run in conjunction with our colleagues in paediatrics.

Antenatal diabetes
We offer gestational diabetes screening to women at higher risk of developing this type of diabetes during pregnancy.

Women with diabetes considering having a child are offered pre-pregnancy counselling and, following pregnancy, joint antenatal clinics with an obstetrician are available. 

These clinics are co-ordinated by our diabetes specialist midwife. Clinics are held at Wycombe hospital every Wednesday morning and Stoke Mandeville hospital on alternate Monday and Thursday afternoons.

Continuous blood glucose monitoring
This is available to specific patients as part of their outpatient care who experience problems in their glycaemic control.

Diabetes renal clinics
Kidney damage (diabetic nephropathy) is one complication arising from diabetes and is associated with increased cardiovascular risk. We manage patients from an early stage to minimise risk, delay the onset of renal failure and liaise as needed with our nephrologists. Specific clinics for diabetes renal disease are offered at Amersham and Stoke Mandeville hospitals.

Diabetic retinopathy
These clinics are run in conjunction with our colleagues in the ophthalmology (eye) department. They assess people who are referred from the diabetes department or by opticians who specialise in diabetic retinopathy.

People with diabetes can develop problems with their eyes. This is more likely if they have had diabetes for a long time or if their diabetes is poorly controlled. Although blindness from diabetic retinopathy is quite rare, it is still important to treat diabetic eye issues before they cause serious problems.

Treatment for diabetic eye problems are undertaken at both Stoke Mandeville and Wycombe hospitals up to three times a week.

InSight
This is a carbohydrate counting course similar to the dose adjustment for normal eating course (DAFNE) for patients with type 1 diabetes. The course is run by specially trained diabetes specialist nurses and dietitians. The course teaches patients how to adjust their insulin depending on their blood sugar, food intake and exercise levels and enables them to better understand how their body reacts to these variables. This service is run at Stoke Mandeville and Wycombe hospitals.

Insulin initiation
Type 2 diabetes is a progressive condition and most patients will need to transfer onto insulin at some stage. Our diabetes specialist nurses provide individual and group education sessions to teach patients the skills to use insulin therapy successfully. Patients are then cared for by their GP for continuing diabetes management in the community.

Insulin pumps
Insulin pumps are for patients with type 1 diabetes who have completed the InSight course. We provide comprehensive support including an initial assessment, full training and ongoing help at outpatient appointments.

Multidisciplinary diabetic foot clinics
We provide treatment and management support for diabetic foot ulceration and charcot arthropathy at weekly clinics, run by our specialist diabetes foot team at each of our three hospitals.

A multidisciplinary foot clinic, designed for patients with complex foot ulceration or charcot arthropathy, is held monthly at Stoke Mandeville and involves a diabetologist, vascular surgeon and podiatrist. The clinic aims to treat this condition as conservatively as possible.