Skip to content
left end
left end
right end

Diabetes services

 

 

Insulin Pump Service

 

The insulin pump therapy service has been running for 10 years, is jointly run by a consultant endocrinologist and a diabetes specialist nurse and is one of the largest pump services in England. We have considerable experience and knowledge about insulin pump therapy and we use and are familiar with many of the pumps currently available and being used in the UK. Currently we do 10-15 insulin pump initiations per year. These are undertaken in small groups or on a one to one basis. The team will also advise on management of pump therapy during any inpatient episodes. This can help to ensure 'patient safety' during their stay in hospital.

 

 

Weekly insulin pump clinics

 

We offer pre-pump assessments for people preparing to start on insulin pump therapy, as well as pump review and trouble shooting clinics for people already using pumps.

 

Structured education

  • 'Pre' pump start sessions

  • Sessions for people 'new' to pumps - three to four months after starting on a pump

  • 'Refresher' sessions for people using pump therapy

    This service is provided by our diabetes specialist nurses
    Tel: 0117 342 2892 
    Email: AdultDiabetesSpecialistNurse@uhbristol.nhs.uk

 

Continuous glucose monitoring (CGM)

CGM provides information about the direction, magnitude, duration, frequency, and causes of fluctuations in blood glucose levels and so gives a much greater insight into blood glucose levels throughout 24 hours. Continuous glucose readings that supply trend information can help identify and prevent unwanted periods of hypo or hyperglycaemia. CGM is offered as a tool to help to 'troubleshoot' problems with diabetes control. This service is led by Lis Jones.

Referrals can be made to the service lead or the diabetes specialist nurses.

Service lead: Dr Natasha Thorogood. 

 

Antenatal Diabetes Service

More information can be found under antenatal endocrinology.

Endocrine service leads: Dr Karin Bradley and Dr Natasha Thorogood. 

 

Cystic Fibrosis Diabetes Clinic

The Bristol Adult Cystic Fibrosis Centre (BACFC) provides high quality multi-disciplinary care to adults with cystic fibrosis in Bristol and the surrounding areas. 50% of people with cystic fibrosis will develop diabetes by the age of 40. Early intervention in treating the diabetes can have a profound impact on patient well-being and protects against weight loss and deterioration in lung function.

The dedicated Cystic Fibrosis Diabetes clinic is co-ordinated by the Cystic Fibrosis team and run by Dr Natasha Thorogood, consultant endocrinologist, jointly with the CF Team. Clinics are held in the Cystic Fibrosis outpatients on the last Thursday of every month.

Service lead: Dr Natasha Thorogood. 

 

Diabetes Specialist Nurse Care pathways/clinics

We accept direct referrals to our clinics at the BRI and South Bristol Community Hospital. Referrals can be made through GPs or practice nurses. We provide expert advice and all round support to help people manage their diabetes effectively in differing life situations. This may be through one to one work or in patient groups. For example:

  • Managing hyperglycaemia and prevention of ketoacidosis

  • Problematic hypoglycaemia

  • Lifestyle issues such as shift work, travel advice, high intensity sport

  • Planning pregnancy. We offer prepregnancy counselling and work as part of the joint endocrinology and obstetric team guiding women with diabetes during pregnancy to achieve the best outcomes

The diabetes specialist nurses are experienced educators who deliver a variety of structured education courses for people with Type 1 diabetes throughout Bristol. 

Rapid access diabetes specialist nurse appointments are available Monday to Friday. Referral criteria for this service are:

  • New diagnosis Type 1 diabetes

  • Early pregnancy Type 1, Type 2 diabetes

  • Frequent and severe hypoglycaemia

  • Hyperglycaemia related to illness or infection

 

To refer, please telephone the diabetes specialist nurses direct on 0117 342 2892. 

 

General/Secondary Care Diabetes

The BRI service hosts weekly diabetes clinics (with Dr Natasha Thorogood, Dr Bushra Ahmad and Dr Rami Fikri) offering complex case management for patients with diabetes. All clinics are consultant supervised and all new and follow up patients are seen by a consultant or a senior specialist registrar. Any patients seen by a senior specialist registrar are discussed with a consultant to finalise the care plan.

The BRI does not offer a formal obesity service. Our closest referral centres for obesity are at Musgrove Park Hospital, Taunton (with Dr Rob Andrews, consultant endocrinologist) and Southmead Hospital (with Dr Andrew Johnson, consultant endocrinologist).

 

Inpatient Diabetes Service

The BRI provides a diabetes inpatient team to support quality of care for patients whose hospital admission is complicated by diabetes. Appropriate care pathways and guidelines are in place. The team includes inpatient specialist nurses dedicated to the Division of Medicine, the Division of Surgery, Head and Neck and the Division of Specialised Services. The endocrinology specialist registrars and consultants also support inpatient care.

Service lead: Dr Rami Fikri.

 

Transitional Care

For young adults making the transition from paediatric to adult care we offer dedicated clinics where consultants from both sides attend to ensure that the handover of care is as optimal as possible.

These are run by Dr Bradley for endocrinology and Drs Thorogood and Yajnik for diabetes.

We work very closely with our paediatric endocrinology colleagues who are based just next door to us in the Bristol Royal Hospital for Children. 

 

 

Community Podiatry Pathway Info

http://www.sirona-cic.org.uk/nhsservices/adult-services/podiatry/

 

Information for patients

  Type 1 Diabetes exercise guidelines (flowchart)

Diasend user instructions