Diabetes and Endocrinology (GP information)
Introduction
Diabetes
At the L&D the Multi-Disciplinary Diabetes Specialist Team offers a comprehensive range of diabetes services for in-patients and out-patients of all age groups, including Children and Young Persons (CYP). There are dedicated Diabetes Specialist Nurses (for adults and CYP), Specialist Dietitians, Specialist Podiatrists, and Consultant led consultations. For out-patients, most of the multi-disciplinary team specialist clinics are held in the dedicated Diabetes Centre or in the paediatric out-patient department.
CYPs with suspected diabetes are seen on the day of referral in the Paediatric Assessment Unit (PAU) and have open access to the unit with 24 hour expert advice for diabetes related issues. The Paediatric Diabetes Nurse Specialist, following diagnosis and when needed, support the family/child in the community setting and at their school. The team provide support and education for the staff at school to support the diabetes.
There is a close working link with both the Luton and Bedfordshire Integrated Community Diabetes Services.
Endocrinology
The L&D is one of the few hospitals providing a comprehensive endocrine service, encompassing common and uncommon endocrine disorders. We work in close collaboration with endocrine surgery, paediatric endocrinology and clinical biochemistry and the endocrine team in Cambridge, Oxford and Great Ormond Street Hospital.
The endocrine team runs out-patient clinics at the L&D to see new referrals and for follow-up of patients with complicated disorders. A high percentage of patients are discharged from their clinic follow-up after their acute problems have settled, but some of the complicated problems receive life-long follow-up. The team also runs a consultation service for in-patients with endocrine disorders and endocrine emergencies. There is an Adult and Paediatric Endocrine Nurse Specialist, who runs nurse led follow up clinics, provides endocrine counselling to patient, pastoral care, and facilities endocrine function tests. There is also a joint endocrine adolescent clinic and outreach clinic from Great Ormond Street Hospital.
Referral Process
- Referrals are accepted via E-RS only.
- For urgent Paediatric referrals please refer to Paediatric Section.
- Bedfordshire ICDS (non-urgent only) referrals can be made by referral letter/ ICDS referral form by post or fax (01582 718051).
Advice and guidance is also offered by consultant physician to GPs for patients who do not require consultations, via the Choose & Book Advice and Guidance Request service portal.
All referrals are seen and triaged by our consultant who leads the service.
Procedures Provided
Diabetes
- Assessment and management of complex diabetes
- Assessment and management of acute and chronic diabetes complications
- Insulin and injectable therapies initiation
- Continuous home blood glucose monitoring
- Structured education programs for patients
- Assessment and initiation of subcutaneous insulin infusion pump therapy
- Group educational sessions
- Rapid assessment and management of acute diabetic foot ulcers
- Support from Clinical Psychologist
- 1:1 teaching on carbohydrate counting
The Bedfordshire Integrated Community Diabetes Service (ICDS) offers the following services for patients who have diabetes and want to improve their glucose control:
- Opportunity for joint diabetes specialist nurse and dietitian appointments
- Telephone, email and face-to-face follow-up appointments
- Group education at the time of diagnosis
- Group education for people with established diabetes
- Group or individual education for those who need to start or improve their ability to self-manage insulin or other injectable therapy
- Group or individual education for those who need to learn to monitor their blood glucose
Endocrinology
Any condition which indicates a hormonal dysfunction (thyroid, pituitary, adrenal, ovaries/testes) are seen in clinic. Other conditions seen are:
- Electrolyte and metabolic disorders
- Secondary hypertension
- Other rare disorders with a strong suspicion of endocrine cause
- Pregnant patients with endocrine problems can be seen at the request of a GP or obstetrics team
Clinics
- Diabetes in the Elderly (over 65s)
- Paediatric (Children)
- Young Adult / Adolescent
- Insulin Pump Clinic
- Adult General Diabetes Clinic (new and follow up)
- High HbA1c Clinic (Paediatric Diabetes Nurse led)
- Joint Diabetes Antenatal Clinic
- Joint Gestational Diabetes Clinic
- Pre-Conception Counselling Clinic
- Diabetic Foot Clinic
Patient Information Leaflets
Clinicians - Consultants/Specialist Nurses
Diabetes and Endocrinology Service
Diabetes and Endocrinology Service
Useful Contacts
Caroline.oakes@ldh.nhs.uk
pals@bedfordhospital.nhs.uk
Caroline.oakes@ldh.nhs.uk
Vassoodeo.kunhya@ldh.nhs.uk
Bleep 256 (via Switchboard)
01582 497578
Podiatry@ldh.nhs.uk
Dionne.Murray@ldh.nhs.uk
Shiu-Ching.Soo@ldh.nhs.uk
Bleep 472 (via switchboard)
PALS@ldh.nhs.uk