Links to other pages within Patient UK which are related to this topic:
Experience | Leaflets | Medicines | Support | Patient+ | Guidelines | Weblinks | Poems | Videos | News | Products | Other
Print options:   Other options:   Bookmark and Share

This is a PatientPlus article. PatientPlus articles are written for doctors and so the language can be technical. However, some people find that they add depth to the articles found in the other sections of this website which are written for non-medical people.

Newly Diagnosed Diabetic

Post your experience

The initial management of someone who has just been diagnosed as having diabetes mellitus can have a big effect on the course of the illness. It is essential to establish a clear understanding of the disease, the benefits of all aspects of management and to allay unnecessary fears and myths quickly. See also separate articles Management of Type 1 Diabetes and Management of Type 2 Diabetes.

Assessment

Indications for hospital referral at initial presentation include:1

  • Children and young people presenting with suspected diabetes should always be referred urgently, on the same day, for admission to hospital for initiation of insulin therapy.
  • Adults who are clearly unwell, or who have ketones in their urine, or who have a blood glucose level greater than 25.0 mmol/l, should also be referred urgently for admission to hospital on the same day.
  • Those who present with diabetic ketoacidosis or diabetic hyperosmolar non-ketotic syndrome will require immediate treatment in hospital.
  • Young adults (aged under 30 years) should also be referred to a specialist diabetes team. The majority will require insulin therapy, but this can often be started without admission to hospital.
Clinical examination and investigations
Initial management
  • Enter patient details on to the practice diabetes register (i.e. add the code for "Diabetes Mellitus" on patient computer record).
  • Register the patient with the local eye disease screening programme (or refer to an optician for a diabetic check).
  • Establish the patient's knowledge and educational needs.
  • Explanation of the condition and its management should be tailored to the educational needs of the patient and take account of their social and cultural background.
  • Ensure all people with newly diagnosed diabetes have the opportunity to share any initial anxieties and concerns about the diagnosis and the implications for their future lifestyle.
  • Include advice on managing diabetes during intercurrent illness.
  • The possible effects of diabetes on occupation, driving and insurance should be discussed. If the person concerned is a driver, they should be advised to inform their car insurance company, and the Driver and Vehicle Licensing Agency (DVLA), if on insulin, oral hypoglycaemics or experiencing diabetic eye complications.
  • They should also be advised that they are exempt from prescription charges if started on medication for their diabetes.
  • Books, leaflets, audio aids and visual aids for the patient to borrow.
  • Diabetes UK: give information about Diabetes UK and details of the local Diabetes UK voluntary group. Diabetes UK also provides a very valuable resource for healthcare professionals and provides educational materials in many languages.
Initial treatment and care
  • Management should be discussed with the patient and commenced as soon as possible.
  • Advice on diet and exercise recommendations for people with diabetes.
  • Prevention of coronary heart disease: all people with diabetes should be advised of the adverse effects of smoking and be offered advice and support to stop smoking. They should also be offered advice and treatment for any other cardiovascular risk factors, including blood pressure control, cholesterol-lowering drugs and low-dose aspirin.
  • All patients with microalbuminuria or proteinuria should be started on an ACE inhibitor, if there are no contra-indications.
  • Insulin therapy should be started immediately in those who are ill at presentation or who have a high level of ketones in their urine. Insulin should also be considered, regardless of age, if one or more of the following are present:1
    • Severe symptoms
    • Acute onset
    • Marked weight loss
    • A first-degree relative has type 1 diabetes
  • People aged less than 40 with diabetes who are asymptomatic and who have a BMI of 25 or above:
    • Should be advised to increase their physical activity levels, adopt a balanced diet and aim to reduce their calorie intake.
    • Insulin should be considered in those who are not obese.
  • People aged over 40 with diabetes who are asymptomatic:
    • Should be advised to increase their physical activity levels, adopt a balanced diet and, if they are overweight or obese, aim to reduce their calorie intake.
    • If blood glucose control is not achieved within three months, treatment with oral hypoglycaemic agents should be commenced.
    • Insulin treatment should be considered if blood glucose control is not achieved with diet, increased physical activity and combined drug therapy.
  • The initial care plan should be discussed and agreed, and a named contact identified who will be responsible for providing support and information. The date of the next appointment should be agreed. Regular reviews will be required initially.


Document references
  1. Diabetes UK; Care recommendations - The provision of services in primary care.

Internet and further reading Acknowledgements EMIS is grateful to Dr Colin Tidy for writing this article. The final copy has passed scrutiny by the independent Mentor GP reviewing team. ©EMIS 2009.
Document ID: 2855
Document Version: 21
Document Reference: bgp917
Last Updated: 17 Sep 2009
Planned Review: 17 Sep 2011

The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.

Patient UK Hearing Impairment Survey

Patient UK are grateful to the 550 people who took part in this survey.
To see the results click here.
If you'd like to leave your feedback, please go to our interactive forum.

Links to other pages within Patient UK which are related to this topic:
Experience | Leaflets | Medicines | Support | Patient+ | Guidelines | Weblinks | Poems | Videos | News | Products | Other
Print options:   Other options:   Bookmark and Share
Want to search some more? Use the Google Search box below to search our site.

Related pages in Patient UK

Your Experience (^ top of page)

 Please add your experience about this condition / medicine
 Diabetes - Diabetic Retinopathy
 Diabetes - Treatments for Type 2
 Diabetes and High Blood Pressure
 Diabetes Foot Care - A Summary
 Diabetes Type 1
 Diabetes Type 1 - A Summary
 Diabetes Type 2
 Diabetes Type 2 - A Summary
 Diabetes, Foot Care and Foot Ulcers

 Insulin

Support Group Abbott Diabetes Care
Support Group Diabetes Insight Website
Support Group Diabetes Lifeline
Support Group Diabetes Research & Wellness Foundation
Support Group Diabetes UK
Support Group Diabetic Foot Page
Support Group Diabetic Retinopathy Screening
Support Group Diabetic Retinopathy Website
Support Group Insulin Dependent Diabetes Trust
Support Group Juvenile Diabetes Research Foundation
Support Group MedicAlert® Foundation

 Assessment of the Established Diabetic
 Diabetes & Intercurrent Illness
 Diabetes Diet and Exercise
 Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND)
 Diabetes Mellitus
 Diabetes, Oral Hypoglycaemic Agents and Exenatide
 Diabetic Audit
 Diabetic Retinopathy and Diabetic Eye Problems
 Dose Adjustment For Normal Eating and Exercise (DAFNE)
 Eye in Systemic Disease
 Glucose Monitoring
 Glucose Tolerance Tests
 Glycosylated Haemoglobin
 Insulin Regimens
 Management of Type 1 Diabetes
 Management of Type 2 Diabetes
 Managing Diabetes in General Practice
 Metabolic Syndrome
 Precautions With Diabetic Patients Undergoing Surgery
 Prevention of Type 2 Diabetes
 Self-monitoring Blood Glucose in Diabetes Mellitus
 Standards and Aims of Diabetic Care
 Urine Glucose Monitoring in Diabetes Mellitus

 Guidelines on Diabetes

 Diabetes
 Diabetic Kidney Disease

 Adam Learns to Cope with Diabetes
 Monkey and Harriet
 Stuart's Type 2 Diabetes

 Links to online videos on Diabetes

Recent related news items

 Dieting 'keeps diabetes at bay'
 Weight loss pills vs anti-fat jab
 Diabetes drug 'trumps fat pill'
 High danger of diabetes for 620,000 Scots
 Nick of time

All news by related topic

 Diabetes news
 Type 2 Diabetes Mellitus news

Medical equipment

 Fitness Aids
 Health Monitors - Blood Pressure
 Health Monitors - Glucose
 Medical Bracelets
 Pill/Tablet Equipment

Visit the Patient UK Medical Equipment shop

Books

 Caring for someone with diabetes
 Diabetes - A Simple Guide
 Diabetes (Living Life with)
 Diabetes (Living with)
 Diabetes (Understanding)
 Diabetes : British Medical Association's Family Doctor Series
 Diabetes for Dummies
 Diabetes Handbook (The)
 Diabetes: At Your Fingertips
 Living Life with Diabetes
 Living with Diabetes
 No Added Sugar: Growing Up with Type 1 Diabetes
 Type 1 Diabetes in Children, Adolescents and Young Adults (3rd Edition)
 Type 1 Diabetes: Answers At Your Fingertips (6th Edition)
 Type 1 Diabetes: No Added Sugar (Growing Up With)
 Type 2 Diabetes: Answers At Your Fingertips (6th Edition)
 Type 2 Diabetes: The First Year

Visit the Patient UK shop

Other - Useful resources (^ top of page)

Pictures, diagrams, photos, images, etc.
Evidence based medicine
Online textbooks and journals
UK Guidelines
Online Videos
Medline
Other good health sites

Want to search some more? Use the Google Search box below to search our site.

Advertisements











Disclaimer: Patient UK has no control over the content of any external links above. Inclusion does not imply endorsement by Patient UK.

Want to advertise on this site? Find out how >>

Clicking here will take you to the foot of this page where you'll find a list of Information Leaflets which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Support Groups which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Medicines & Drugs which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of diagrams which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of PatientPlus (detailed reference) articles which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of UK Guidelines which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of other selected websites which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Poems and Stories which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Operations and Procedures which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Online Videos which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find links through to our interactive forum.
Here you can follow a link to view existing patient experiences on this subject, or to add your own
Clicking here will take you to the foot of this page where you'll find links to news stories on this subject in our Online Newspaper
Clicking here will take you to the foot of this page where you'll find links to related products
Clicking here will take you to the foot of this page where you'll find links to other useful sources of information
Click here to open a printer-friendly version of this document, in a new window, together with the print dialogue box
Click here to open this document in PDF format
This will offer you the usual PDF options i.e. document navigation, search, zoom and formatted print
Note: this is the best way to print the document
Click here to listen to the MP3 audio recording of this document
Click here to download the audio recording of this document as a podcast, for listening to at your leisure
Click here to open our Dictionaries and Glossaries page
Click here to see related products in our Online Pharmacy
Note: this will open in a new window
Click here to add this page to a social bookmarking site of your choice
Click here if you want to find out more about social bookmarking. This link will take you to the Wikipedia explanation
Note: this will open in a new window
Clicking here will take you to the foot of this page where you'll find a list of Information Leaflets which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Support Groups which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Medicines & Drugs which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of diagrams which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of PatientPlus (detailed reference) articles which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of UK Guidelines which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of other selected websites which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Poems and Stories which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Operations and Procedures which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Online Videos which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find links through to our interactive forum.
Here you can follow a link to view existing patient experiences on this subject, or to add your own
Clicking here will take you to the foot of this page where you'll find links to news stories on this subject in our Online Newspaper
Clicking here will take you to the foot of this page where you'll find links to related products
Clicking here will take you to the foot of this page where you'll find links to other useful sources of information
Click here to open a printer-friendly version of this document, in a new window, together with the print dialogue box
Click here to open this document in PDF format
This will offer you the usual PDF options i.e. document navigation, search, zoom and formatted print
Note: this is the best way to print the document
Click here to listen to the MP3 audio recording of this document
Click here to download the audio recording of this document as a podcast, for listening to at your leisure
Click here to open our Dictionaries and Glossaries page
Click here to see related products in our Online Pharmacy
Note: this will open in a new window
Click here to add this page to a social bookmarking site of your choice
Click here if you want to find out more about social bookmarking. This link will take you to the Wikipedia explanation
Note: this will open in a new window
Click here to return to the home page
Click here to read our 'About Us' page
Go to the Emis Access website, where you can book an appointment with your GP, order a repeat prescription or view you medical record online.
Note: this will open in a new window
View and/or join in discussion about health, lifestyle and disease in our interactive forum.
Note: this will open in a new window
Go to our pharmacy product price comparison pages.
Go to our online newspaper for current medical news and commentary.
Note: this will open in a new window
Adverts on this site do not influence the medical content. Click to read more.
Adverts on this site do not influence the medical content. Click to read more.