• Introduction to diabetes
• Treatment & your health
• Living with diabetes
• What care to expect
• From the NHS
• From your healthcare team
• InfoBank - your local care
• In hospital
• At your annual review
• Your responsibilities
• Complaints
• Complications
• Food and recipes
• Educational events
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At your annual review

Annual Review Checklist

It is important to remember that your annual review is to enable you to lead a normal and healthy life. It must be about what you want and need as well as what healthcare professionals recommend.

 The following should be checked at least once a year:

Laboratory tests and investigations

• Blood glucose control: an HbA1c blood test will measure your long-term blood glucose control. The range to aim for should be 6.5 per cent or below. 
• Kidney function: urine and blood tests to check for protein will show that your kidneys are working correctly. There should not be any protein in your urine.
• Blood fats (lipids, cholesterol and triglyceride levels): a blood test that measures your blood fat levels. A total cholesterol of below 4.0mmol/l or less and a fasting triglyceride of 1.7mmol/l or below are accepted as national target ranges.*

*Please note all normal and good ranges will vary from person to person — it is meant to be a guide so you know what to aim towards. If you have any questions, ask your diabetes care team.
 

Physical examinations

• Weight is often calculated as a Body Mass Index (BMI) which expresses adult weight in relation to height. From this you will be advised if you need to lose weight to better control your diabetes. Your GP will record your BMI in your notes.
• Legs and feet should be examined to check your skin, circulation and nerve supply. If necessary, you should be referred to a state registered chiropodist/podiatrist.
• Blood pressure should be taken. You should aim for your blood pressure to be at or less than 130/80. If it is at higher levels discuss this with your doctor to discuss why your blood pressure may be high. Keeping your blood pressure down has been proven to be beneficial for people with diabetes (UKPDS research trails).
• Eyes should be examined regularly through a ‘fundoscopy’ review where your pupils are dilated to enable your optometrist/ophthalmologist to detect any early changes at the back of the eye (retinopathy). Photographs may be taken to record the appearance at the back of your eyes.

If you’re on insulin, your injection sites should be examined.

Lifestyle issues

The review should also provide enough time to discuss:

• Your general wellbeing; how you are coping with your diabetes at home, work, school or college.
• Your current treatment.
• Your diabetes control, including your home monitoring results and hypos.
• Any problems you may be having.

It should include discussion about smoking, alcohol consumption, stress, sexual problems, physical activity and healthy eating issues. You should feel free to raise any or all of these issues with your diabetes care team.