Find assessment and management information at Brisbane South HealthPathways under:
Useful management information
- For chronic disease management consider GPMP/TCA management plan
- LEADS (Logan Endocrine and Diabetes Services) is running a pilot Diabetes Ramadan Preparation clinic in the lead up to Ramadan to help patients prepare to fast safely. If your patient has Diabetes (Type1 or Type 2) and would like advice on how to prepare for Ramadan , please refer via the usual pathways and ensure that you identify that your patient is participating in Ramadan.
- LEADS (Logan Endocrinology and Diabetes Services) Young Adult Diabetes clinic is for patients aged 16-25 years who require diabetes care. The purpose of the clinic is to provide support to young adults living with diabetes and ensure a smooth transition to adult services.
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-9
- Consider external options for patients including:
- Ausroads Assessing fitness to drive
Minimum referral criteria (Does your patient meet the minimum criteria?)
Does your patient meet the minimum referral criteria?
Category 1
(appointment within 30 calendar days) If you feel your patient meets Category 1 criteria, please mark "urgent" on your referral | - 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) OR major episode of hypoglycaemia
- 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. For optimum care, face to face or telephone review should be seen within 1 week.
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Category 2
(appointment within 90 calendar days) | The following category 2 cases can be referred to local/regional general physician if endocrinologist access is not locally available. - 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
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Category 3
(appointment within 365 calendar days) | - Self-management education or difficulties in managing diabetes in the absence of adequate community resources
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If your patient does not meet the minimum referral criteria
- Assessment and management information can be found on a range of conditions at Brisbane South HealthPathways
- 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 (To be included in all referrals)
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
- A comprehensive capture of information in relation to MSH Referral Criteria
Clinical modifiers
- The presence of clinical modifiers may impact the categorisation of the patient.
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living functioning – low/medium/high
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
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 for Diabetes mellitus referrals (Referral will be returned without this)
- 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)
- FBC ELFT fasting lipids – cholesterol LDL HDL Tg
- Urine albumin:creatinine
If a specific test result is unable to 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 for Diabetes mellitus referrals
- Copy of GPMP/TCA
- Ankle brachial pressure index (ABPI)
- Licence status
- Results of depression screening (PHQ-2) [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
- Please indicate if your patient would benefit from Telehealth service
NB: For patients being referred for driving licence renewal assessment, please also include optometry report.
