What to expect when you have just been diagnosed

When you have just been diagnosed, you should:

• have a full medical examination and discuss with a member of your diabetes healthcare team any immediate treatment you need; your concerns and unanswered questions; your feelings and reaction to being diagnosed.
• receive an explanation of what is on offer for you to learn more about diabetes and keeping well. This includes diabetes structured education and general self-management courses, as well as other sources of information and support.
• see a registered dietitian (either an individual appointment or as part of a group education course) to discuss what you usually eat, how this relates to your diabetes, and what other information and support will guide you to eat a healthier diet.

Coming to terms with diagnosis

Diabetes does not wait for a convenient time in life to be diagnosed.

It is not unusual for people to experience some of the following thoughts and feelings:

• I was healthy and now I’m ‘ill’ – it feels unfair and I’m angry/depressed.
• What I eat may be risky and that makes me anxious.
• I have to change my whole life, what if I can’t manage?
• It’s all my fault.
• If I change my lifestyle perhaps my diabetes will go away.
• Complications are inevitable.
• My body is out of control, I feel helpless.

These feelings are very common and part of the process of adapting to having diabetes. Having thoughts like these does not mean that you are not coping but maybe that you need more information or support.

What to expect with your treatment

If your diabetes is treated by insulin your care should include:

• contact either, face-to-face, telephone, email or text messages with your healthcare team. This will be frequent at first, as you learn how to inject, look after your insulin, syringes, insulin pen, or insulin pump and how to dispose of needles known as sharps.
• being shown how to test your blood glucose and test for ketones (if appropriate) and be informed what the results mean and what to do about them.
• being given supplies of, or a prescription for, the medication and equipment you need.
• a discussion about hypoglycaemia episodes, often referred to as hypos, when and why they may happen and how to deal with them.
• an examination of your injection sites to check insulin can be absorbed properly.

If your diabetes is treated by other medication or by healthy eating and physical activity, your care should include:

• information about testing your blood or urine glucose at home and a discussion of what the results mean and what to do about them.
• supplies of, or a prescription for, the medication and equipment you need.
• a discussion about hypoglycaemia (hypos) episodes if relevant to your treatment, when and why they may happen and how to deal with them.

What to expect from your ongoing care

Once you have received initial information and treatment, your ongoing care includes:

• a formal annual care planning review with a doctor or nurse experienced in diabetes. This should include a discussion of your tests, examinations as well as your experiences of living with diabetes and any other concerns, needs or anxieties.
• an eyesight test once a year.
• regular access to your diabetes healthcare team to assess your diabetes control. This could be every four to six months, or as agreed in your care plan. You should have time to ask questions and to discuss your care.
• access to a member of your diabetes healthcare team for specific support and advice when you need it. This could be in person or by phone, email or text messages, depending on what methods are used locally.

What to expect on a regular basis

As part of your ongoing care your diabetes healthcare team is there to support you to manage your diabetes. They will:

• provide continuity of care, ideally from the same doctors and nurses, or if this is not possible, doctors or nurses who are fully aware of your medical history and background and are experienced in diabetes.
• work with you to continually review and update your care plan, including your diabetes management goals.
• make sure that you understand and are involved in the decisions about your treatment or care. This means having access to your results with information about what they mean, so you can ask questions and make sure your personal goals are reflected in copies of any communications about you.
• ask you about how you are feeling and give you information about what emotional and psychological support is available locally
• if you need it, organise pre- and post-pregnancy advice together with your obstetric team.
• encourage you to gain support from your friends, partner and/or relatives and from other people with diabetes.
• provide you with ongoing education sessions, appointments and information on different ways you can learn about diabetes, for example websites, books, leaflets, support groups, courses and conferences
• offer you a review with your GP/ Practice Nurse.
• give you information on the effects of diabetes and treatments when you are ill or taking other medication.
• give you information about how to dispose of your used sharps (insulin needles and/or blood glucose monitoring lancets) and local arrangements for collection of sharps disposal boxes
• help you access specialist services when you need them, for example specialist foot services.

Further Information and Advice

If you have any queries, concerns or need advice about your diabetes, please contact your GP or Practice Nurse.

Helpful Resources

Diabetes UK:Newly Diagnosed: For all you need to know about being newly diagonised including tips for keeping active and advice on your diet.

Glossary: Confused by words like glucagon and diabetic retinopathy? Cut through the medical jargon with these easily understandable definitions of diabetes-related terms.

My Diabetes Book: A handy, pocket-sized guide that allows patients to plan goals and targets, as well as track their progress and record information received during consultations.