Type 2 diabetes

Type 2 diabetes — referral criteria for Endocrinology services.

Full SRC reference

Eligibility

At least one must be met for the patient to be eligible for referral.

Clinically suspected or confirmed type 2 diabetes with initial primary-care work-up completed

Red flags

Indicate urgent (Category 1) referral or emergency assessment.

Diabetic ketoacidosis or suspected diabetic ketoacidosis (e.g. abdominal pain, dehydration, confusion, nausea and vomiting)

Hyperosmolar hyperglycemic state

Diabetes and severe vomiting

Acute, severe hyperglycaemia

Acute, severe hypoglycaemia

Suspected Charcot’s neuroarthropathy (e.g. unilateral, red, hot, swollen, possibly aching foot)

Foot ulceration with absent pulses

Pregnancy in known diabetic woman

Recent, resolved hypoglycaemia episode resulting in unconsciousness

Routine referral criteria

Determine Category 2 or 3 urgency.

Type 2 diabetes not responding to a combination of dietary AND medical management (i.e. has tried at least three glucose-lowering medicines) with HbA1c greater than 64 millimoles per mole or 8 percent

Patients with type 2 diabetes with complications (e.g. cardiovascular disease, kidney disease, retinopathy, cerebral vascular disease, neuropathy)

Planning for pregnancy

Management of unstable glycaemic control due to concomitant use of medicines that impact on glycaemic control (e.g. corticosteroids, chemotherapy protocols)

Assessment for commercial driver’s licence

Diagnosis of type of diabetes

Usually managed in primary care

Well controlled type 2 diabetes (responding to dietary and medical management with HbA1c less than 64 millimoles per mole or 8 percent) without any complications or comorbidities
Patients being managed with dietary measures alone