1Start here234567891011121314151617 Do you care for, or support a person with disability and diabetes? The yearly diabetes care checklist, otherwise known as the diabetes annual cycle of care, is a tool to help you understand what diabetes health checks are recommended, and when. The checks reduce the risk of diabetes-related health issues, such as damage to the blood vessels, and other parts of the body such as the kidneys, eyes, feet, nerves and heart. To get a checklist of the recommended diabetes health checks for the person you support, please click “Start checklist” and answer some simple questions. It only takes a few minutes. At the end, you will get a list of health checks that you can save or print and take to the person’s next health appointment. This appointment may be with their general practitioner (GP), nurse practitioner (NP), credentialled diabetes educator (CDE) or diabetes healthcare team. They can talk to you both about the list and provide personalised advice on next steps. Blood checks (having blood taken from a vein) Some of the checks recommended in the diabetes care checklist involve having blood taken from a vein (a blood check). For some people with disability, this can make it more difficult to have diabetes health checks done.Is the person you support able to have a blood check done?* Yes No Support them in the same way you usually do when they have blood taken.Tell their endocrinologist, GP, or NP about the issue and ask how the person you support can be assisted in having their blood taken. For example, it may be possible to have the blood check done at home, or there may be a sedation clinic they can be referred to. They may also benefit from seeing a psychologist via their National Disability Insurance Scheme (NDIS) Plan. HbA1c check An HbA1c (glycated haemoglobin) is a blood check that is a measure of the average blood glucose level over the past three months. You may have heard it called a long-term blood glucose check. This check helps assess how their diabetes treatment plan is working, or if changes are needed. It is recommended an HbA1c check is done by the endocrinologist, general practitioner (GP) or nurse practitioner (NP) every 6 to 12 months.Have they had their HbA1c checked within the last 6-12 months?* Yes No Ask their GP, endocrinologist or NP when their next HbA1c blood check is due.Ask their GP, endocrinologist or NP for a referral to pathology to have their HbA1c checked. Blood pressure check Regular blood pressure checks help monitor the health of the heart and blood vessels (cardiovascular system). Keeping blood pressure in the healthy range helps reduce the risk of heart disease, stroke, and kidney damage, which are more common in people with diabetes. Blood pressure should be checked at least every 6 months. Have they had their blood pressure checked within the last 6 months?* Yes No You could check their results to see if they are within a healthy range and if needed, discuss with their health professional how they can be supported to achieve their target range.Ask their health professional or local pharmacist to arrange for their blood pressure to be measured. Foot checks Yearly foot checks by a GP or podiatrist are important to find and treat any diabetes-related foot issues early. The podiatrist can also provide physical support for the feet with the use of orthotics (shoe inserts), if needed. Healthy feet help people with diabetes to walk, which is important for their quality of life. Foot checks look at the blood supply and feeling in the feet. For those in a wheelchair, a physiotherapist can monitor foot and leg safety to prevent injury to feet and legs when using their wheelchair. Daily foot care is also essential. This includes you or the person you support getting to know their feet and checking for any changes, including on the bottom of their feet and between their toes. More information about daily foot care and foot risk can be found on the Foot Forward website. If the person you support has had a toe, foot or leg amputation, it is a priority to protect their remaining toes, foot or leg as recommended.Have they had a foot check by their GP or podiatrist within the last 12 months?* Yes No Ask their GP about getting a foot check from a podiatrist. Their GP may start a GP Management Plan which offers a Medicare rebate to see a podiatrist. Private health insurance may also cover the cost of a podiatrist.Make sure you continue to report any changes your healthcare team. Visit a podiatrist for a foot check every 6–12 months. Their GP will renew their GP Management Plan every 12 months, which offers a Medicare rebate to see a podiatrist. Eye checks Eye checks look for early signs of diabetes-related eye damage. Regular eye checks help treat eye damage early. An optometrist or eye specialist should check their eyes at least every two years to reduce the risk of diabetes-related eye conditions (such as diabetic retinopathy, cataracts, and glaucoma). If these conditions are left untreated, they can cause permanent damage or loss of vision.Have they had their eyes checked by an optometrist or eye specialist within the last 2 years, or as recommended?* Yes No Ask their GP about getting an eye check from an optometrist. These eye checks are usually covered by Medicare. Continue to visit an optometrist or eye specialist for an eye check every two years, or earlier if advised to do so. Diabetes Australia has a free program to support staying up to date with an individual’s eye health checks called KeepSight.Re-visit the optometrist or eye specialist for an eye check every two years, or earlier if advised to do so. These eye checks are usually covered by Medicare. If they see an eye specialist, ask their GP if they need a new referral letter. Diabetes Australia has a free program to support staying up to date with an individual’s eye health checks called KeepSight. Kidney health check Yearly urine and blood tests are important to check kidney health. Monitoring kidney health is important as diabetes can increase the risk of damage to the kidneys (diabetic nephropathy), a serious condition that can lead to kidney failure.Have they had urine and blood check within the last 12 months to assess their kidney health?* Yes No Ask their GP, endocrinologist or NP for a referral to have their kidney health checked.If you have any concerns make sure you discuss them with their healthcare team. Blood lipid (blood fat) check Regular blood lipid (blood fat) checks monitor cholesterol and triglyceride levels. Cholesterol and triglyceride levels that are within their target range help reduce the risk of blood vessel damage that can cause heart disease and stroke. A blood check of their blood fats should be done at least once a year.Have they had a blood check within 12 months to check their blood lipid levels (cholesterol and triglycerides)?* Yes No Check the results with their GP and discuss whether any action is needed to achieve their target range.Ask their GP, endocrinologist or NP to arrange for their blood lipids to be measured. Maintaining a healthy weight range and waist measurement Weight and waist measurements are important indicators of health risks. They are best checked every 6 months or as recommended by their health professional. A healthy weight range will be different for everyone. A healthy weight helps reduce the risk of heart and blood vessel disease and stroke. It also helps protect against falls and injury from falls. If you notice unexpected weight loss in the person you care for or support, it is important to talk to their health professional. If the person you care for is resistant to having their weight taken or has a history of disordered eating, suggest a ‘blind weight’ be taken where the person cannot see the number on the scale.Have they had their weight and waist measurements checked within the last 6 months?* Yes No Ask for a check of their weight and waist measurements at the next health professional appointment if relevant to the health goals of the person you care for. If there was a change in their weight or waist measurements, discuss this with their health professional. Healthy eating A balanced diet rich in fruits, vegetables, whole grains, and lean proteins helps manage weight, and helps keep blood glucose levels within their target range. Making informed food choices, limiting processed foods, and eating the right portion-sized meals will help promote overall health and wellbeing for people with diabetes. A visit to a dietitian is recommended every 12 months. Does the person have a healthy eating plan in place as developed by an accredited practising dietitian (APD)?* Yes No Ask their GP for a referral to a dietitian for advice about healthy eating and their nutritional needs. Their doctor may start a GP Management Plan which offers a Medicare rebate to see a dietitian. Private health insurance may also cover the costs of seeing a dietitian. Poor oral health can also impact on diet. Blood glucose levels above someone’s target range increases the risk of dental problems such as tooth decay, and gum infections or disease. Speak to their GP, NP or dentist if you are concerned about gum disease, mouth or tooth pain. Ask the GP when their next visit to a dietitian is due. A GP Management Plan can offer a Medicare rebate to see a dietitian. Private health insurance may also cover the costs of seeing a dietitian. Physical activity It is important to support people with disability to be physically active. If they include physical activity most days of the week, they reduce the risk of diabetes-related health issues. Physical activity also improves overall health, mental wellbeing, and quality of life. Activity choice may depend on personal preference and their disability. Any physical activity is better than no physical activity. Doing moderate-intensity activities such as brisk walking, brisk wheelchair wheeling, cycling or hand cycling for at least 30 minutes a day, along with muscle-strengthening activities, helps keep blood glucose levels in target range and supports heart and blood vessel health. People who rely on a wheelchair can have exercise programs designed for their specific needs.Are they doing regular physical activity for at least 30 minutes per day?* Yes No Ask their GP or NP for a referral to an exercise physiologist for advice about physical activity, and exercises to improve muscle strength and balance. A GP Management Plan, private health insurance or NDIS may subsidise or cover the costs of an exercise physiologist. If they are living with type 2 diabetes, they may also be eligible to attend a type 2 diabetes group education program run by diabetes educators, exercise physiologists and dietitians in their local area. Visit an exercise physiologist every 12 months.If you feel they need more support or a change to their physical activity plan, a GP Management Plan, private health insurance or NDIS may subsidise or cover the costs to see an exercise physiologist. Review their physical activity plan every 12 months. Medication review A medication review, such as a Home Medication Review, every 12 months can answer important questions about prescription and over-the-counter medicines. This can include how the medication works, the best time to take it, and the possible side effects.Has their GP or pharmacist reviewed their medications within the last 12 months to make sure they are safe and being taken correctly?* Yes No Ask their GP for a medication review or a referral to a pharmacist for a Home Medication Review. Usually, their GP will choose an accredited community pharmacist who will come to their home at a convenient time.A medication review should be done at least once every year. Ask their GP when they can have another review to help with future health review planning. Smoking Quitting smoking lowers the risk of diabetes-related health issues, improves overall health, and supports a healthier lifestyle. Smoking increases the risk of many health issues including heart and blood vessel (cardiovascular) disease. Quitting smoking reduces this risk and improves long-term health and wellbeing for people with diabetes.If they smoke, has their GP or NP discussed a treatment plan for quitting smoking?* Yes No Not applicable Talk with their GP or NP about options to quit smoking or call the Quitline on 13 QUIT or 13 7848. Follow the advice of their GP or NP. If they need further support, call the Quitline on 13 QUIT or 13 7848. Emotional health The demands of living with diabetes and disability can take a toll on emotional wellbeing. Looking after emotional health is as important as looking after diabetes and should be part of their routine diabetes care with their health professional.Have they discussed their emotional health with their health professional as part of their routine diabetes care?* Yes No Encourage the person you care for to discuss the emotional impact of living with diabetes with their GP, or offer to discuss it on their behalf. Diabetes can be tough to live with and impact emotional health. There are a range of mental health professionals who can provide support. Their GP may start a GP Management Plan which offers a Medicare rebate to see a mental health professional. Private health insurance may also cover some of these costs. For immediate 24/7 mental health assistance, contact Lifeline on 13 11 14 or text 0477 13 11 14.Emotional health can change a lot when managing diabetes. Additional support is available from mental health professionals if needed. Their GP may start a GP Management Plan which offers a Medicare rebate to see a mental health professional. Private health insurance may also provide some cover for this. For immediate 24/7 mental health assistance, contact Lifeline on 13 11 14 or text 0477 13 11 14. Sick day management Being unwell can affect blood glucose levels. This is because blood glucose levels can be affected by increased stress hormones, vomiting, diarrhoea, and poor appetite. A Sick Day Action Plan has step-by-step written instructions on how to manage diabetes when they are unwell or have an infection. It is important for people with diabetes to have a current Sick Day Action Plan ready to use at the first sign of illness. People with disability and diabetes may need their support workers to start their Sick Day Action Plan.Do they have a Sick Day Action Plan in place?* Yes No Speak to their GP, NP or credentialled diabetes educator to ensure the Sick Day Action Plan is reviewed every 12 months. If the person has a support worker or team, speak to their NDIS Support Coordinator about providing the Sick Day Action Plan and any training to the person’s support workers so it can be put into action. Book an appointment with the GP, NP, diabetes specialist or credentialled diabetes educator to put a Sick Day Action Plan in place. The plan should be reviewed every 12 months and provided to anyone who supports or cares for the person. Vaccinations Vaccinations are essential for people with disability to maintain their health, independence, and quality of life. By staying up to date on recommended vaccines, they can reduce their risk of serious illnesses, and help protect themselves and others in their community. Have they discussed what vaccinations they need with their health professional?* Yes No If some vaccinations need to be updated, make an appointment at the general practice, pharmacy or local council service for the vaccinations to be given. To stay up to date on the latest information about vaccinations visit Department of Health and Aged Care.Ask the GP or NP at the next appointment if their vaccinations are up to date. If they need to have vaccinations, arrange for them to be given at the general practice, pharmacy or local council service. To stay up to date on the latest information about vaccinations visit Department of Health and Aged Care. {all_fields}
