• Assessment on next step in treatment
• Uncertainty about classification of diabetes
• Insulin initiation
• Insulin dose adjustment
• GLP-1 initiation
• Severely insulin resistant patients
• Multiple co-morbidities
• Patients needed Specialist Multidisciplinary Support from psychologist, diabetes specialist nurse, specialist diabetes dietician, consultant diabetologist
• Patients with CKD stage 4 (eGFR < 30ml/min) and/or creatinine > 150µmol/l)
• HAB1c persistently higher 78 mmol/mmol
• Home visits of house bound diabetes patients
• Basic carbohydrate counting for Type 2DM patients on basal-bolus insulin regimen
• Education courses for type 2 DM (DESMOND): newly diagnosed and ongoing diabetes
• Professional practice-based education

Patients triaged by the community diabetes team have one or more of the following possible outcome(s):

• Patient seen at weekly rapid-access diabetes consultant clinic
• Patient seen at the next joint practice-based clinic with GP/PN  in the patient’s surgery
• Home visit by DSN / Community Nurse or Matron
• Patient referred to hospital diabetes clinic or other specialist clinic