Diabetes and Renal disease service

Diabetes and Renal disease are common co-morbidities both because of the direct relationship (nephropathic complications of diabetes) and because of the fact that therapies for renal diseases can often result in dysglycaemia.

Close metabolic control of diabetes and recognition of the impact of early CKD complications can result in significant outcome and quality of life (QOL) benefit for patients with renal disease, and conversely, renal disease can have a significant impact upon the effects of metabolic interventions and their safety, making this area an ideal target for specialist services where expert knowledge and skills along with individualised care-planning will reap rewards for the individual affected.

PHT Diabetes team therefore offers specific specialty services for patients with diabetes and chronic kidney disease especially where the stage of disease has reached stage 3b (eGFR 30-45mls/min) and stage 4&5 (eGFR <30)

Patients are seen on average three monthly, insulin and oral medications titrated to optimise risk/benefit ratios in liaison with renal support services and the renal physicians.

Clinic Services:

• Insulin assessments to complement haemodialysis requirements
• Insulin assessments to complement peritoneal dialysis requirements
• Insulin initiation in patients with significantly impaired renal function
• Early Renal complications screening and therapy prior to replacement requirement
• Metabolic support of renal transplant patients on immunosuppression (and treatment planning for NODAT)
• Diabetes input and review services (footcare / eyecare) for dialysis-dependent patients

Medical Lead:                        Iain Cranston

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Nurse Lead:                           Joanne Buchanan