Diabetes mellitus

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Useful Management Information

For chronic disease management consider GPMP/TCA management plan
For management in primary care:
- Stable existing type 2 diabetes
- Newly diagnosed type 2 diabetes and not acutely unwell
- Dietary advice for weight reduction, high cholesterol, hypertension or CVD in client with diabetes
- Impaired glucose tolerance or impaired fasting glucose
- Achieving optimal glycaemic control from diagnosis of type 2 diabetes has been shown to improve overall survival and reduce complications
Depression screening tool Phq-2
Consider external options for patients including:
Ausroads Assessing fitness to drive

Minimum Referral Criteria

Category 1	Pregnancy in patient with existing diabetes. For optimum care, patient should be seen within 1 week Newly diagnosed GDM. For optimum care, patient should be seen within 1 week. Poorly controlled diabetes with recent deterioration despite escalation of therapy (HbA1c >86mmol/mol or 10%) Major hypoglycaemic episode (assistance has been required by a third party) Existing type 1 diabetes with newly diagnosed coeliac disease Existing diabetes with recent unintentional weight loss (> 5% of body weight over a month period) Diabetes requiring optimisation in the presence of severe vascular complications, for example stage 3 CKD, proliferative retinopathy, gastroparesis Diabetes with disordered eating Diabetic foot ulcer – refer to high-risk foot criteria Post DKA Admission
Category 2	Diabetes requiring optimisation in the presence of uncontrolled risk factors for chronic vascular disease (CVD)\ Unsatisfactorily controlled diabetes with recent deterioration despite escalation of therapy (HbA1c 64-86mmol/mol or 8-10%) High-risk (but currently not ulcerated) foot in client with diabetes Pre-pregnancy planning Private or commercial driver’s licence who require a new or renewal of conditional licence Stable type 1 diabetes For consideration or commencement of continuous glucose monitoring or continuous subcutaneous insulin infusion pump
Category 3	Self-management education or difficulties in managing diabetes in the absence of adequate community resources
If your patient doesn't meet the minimum referral criteria If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service.

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Type of diabetes and duration of disease
Details of all treatments offered and efficacy
Medication history
Presence of any complications and details when screening last performed
Height, weight, BMI
BP
History of smoking
HbA1c (current and previous results)
FBC
ELFT
Fasting lipids – cholesterol LDL HDL Tg results
Urine albumin: creatinine results

If a specific test result cannot be obtained due to access, financial, religious, cultural or consent reasons a clinical override may be requested. This reason must be clearly articulated in the body of the referral.

Additional Referral Information

Copy of GPMP/TCA
Ankle brachial pressure index (ABPI)
Licence status
Results of depression screening (PHQ-2)
- over the last 2 weeks, how often have you been bothered by any of the following problems?
  - little interest or pleasure in doing things?
  - feeling down, depressed, or hopeless?
If Type 1 diabetes: TSH, anti-transglutaminase antibodies, IgA for coeliac disease within the last 5 years
If peripheral neuropathy: B12 folate

Send Referrals To

Smart Referrals

Coming Soon

Internal Referrals

Diabetes/Endocrinology (E-Blueslips)

Fax

5687 4497

Post

Booking and Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 559 083

Service Availability

Facilities

Gold Coast University Hospital

Robina Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.