Ensure the patient has an adequate care team. This may include:
diabetes nurse specialist
dietitian
podiatrist
endocrinologist
nephrologist
neurologist
cardiologist
ophthalmologist
vascular specialist.
Getting to know patients with type 2 diabetes and poor glycaemic control
One size does not fit all. ‘People with type 2 diabetes and poor glycaemic control (HbA1c >64 mmol/mol) are at increased risk of developing diabetes-related complications and cardiovascular disease (see Standard 3). Engaging with these patients and helping them overcome their individual barriers to achieving a healthier life are a priority for primary care. Where possible, the family/whānau of the patient should be encouraged to be involved in lifestyle changes. Diabetes management plans should be agreed upon using a shared decision-making approach. Treatment targets, including glycaemic control, need to be individualised taking into account patient characteristics, such as age, treatment preference or the presence of comorbidities. Primary care, nurse-led diabetic clinics are an effective way of engaging with and monitoring patients with type 2 diabetes’ (www.bpac.org.nz/BPJ/2014/February/docs/BPJ58-diabetes.pdf).
