Below are all the ways, that we help implement chronic disease management for long term conditions.
Diabetes
Type 1
Lack of insulin, usually starts in youth, requires insulin treatment
Type 2
Body becomes insulin resistant, often linked to obesity, may require diet, tablets, or insulin
Annual checks
- Blood sugar control (HbA1c), kidney function, cholesterol, urine protein
- Every 6 months: Blood pressure check
- Annual comprehensive check: Weight, feet, nerves, circulation
- Annual eye screening for damage
Asthma
Airways constriction causing wheezing, shortness of breath, coughing.
Triggers include: Exercise, dust, weather changes, infections.
Annual check
- Symptom control
- Peak flow measurement
- Inhaler technique
- Trigger identification
COPD (chronic obstructive pulmonary disease)
Permanent airway obstruction, often from smoking, stopping smoking is crucial to slow progression.
Annual check
- Spirometry (lung function test)
- Inhaler technique
- Breathlessness assessment
Ischaemic heart disease (IHD)
Blocked arteries supplying heart, causing chest pain or exercise limitations.
Annual checks
- Blood tests (glucose, cholesterol)
- Weight
- Blood pressure
Hypertension (high blood pressure)
- Regular checks every 6 months for blood pressure
- Initial blood tests for cholesterol and glucose
Cerebrovascular disease (stroke/TIA)
- Blood pressure checks every 6 months
- Annual blood tests for cholesterol and glucose
Chronic kidney disease (CKD)
- Monitoring kidney function decline
- Blood pressure checks every 6 months
- Annual urine protein check
Mental health
Annual check for patients on antipsychotics:
- Blood test
- Examination
- Discussion
Remember, regular monitoring and management are essential for controlling chronic conditions and reducing complications. Discuss any concerns with our healthcare team.