Bay Navigator

Clinical Pathways

Pre-Operative Pathways
Pre-Operative Diabetes Mellitus

Background

This pathway demonstrates the approach to uncontrolled diabetes if detected at pre-assessment. The pre-assessment team give the patient a letter to present to their GP indicating that the HbA1c requires optimisation. The patient will be contacted by pre-assessment six months later, and if no further action has been taken it is possible that their elective operation will be cancelled.

Definition

HbA1c ≥ 69mmol/mol

  • Procedure on hold
  • Pre-operative optimisation required

Management

  1. Optimise if possible in general practice
  2. If Hba1c < 69mmol/mol
    • Patient to notify Pre-Assessment Clinic
      • On completion of treatment, please ask the patient to notify the Pre-Assessment Clinic (PAC).
      • The contact details are on their letter from PAC. The telephone number is 07 579 8260, or email address is Tga.preassessment@bopdhb.govt.nz
  3. If Hba1c ≥ 69mmol/mol
    • Consider specialist referral
    • Patient to notify Pre-Assessment Clinic
      • On completion of treatment, please ask the patient to notify the Pre-Assessment Clinic (PAC).
      • The contact details are on their letter from PAC. The telephone number is 07 579 8260, or email address is Tga.preassessment@bopdhb.govt.nz

Information

Pathway developed by the following people:

Name Position

Dr Daniel Jackson

GP Liaison/Bay Navigator Lead

Dr Renee Franklin

Anaesthetist, PAC

Esther Walker

Associate Clinical Nurse Manager, PAC

Wendy Carey

Programme Manager, SIU

Helen De Vere

Programme Manager, SIU

Disclaimer: These pathways, for the care and management of patients within Bay of Plenty, have been developed jointly by primary and secondary care clinicians. They provide guidance for General Practice teams to diagnose and manage patients suffering from a number of different conditions, and contain patient information resources. The pathways are maps of publicly-funded services accessed by referral from the community, and are strongly evidence based, but are not full clinical guidelines. As the pathways are suggested guidance only, while using them you must exercise your own clinical judgement and pertinent clinical data when treating your patient. This site is intended to be flexible and frequently updated. While every effort has been made to ensure accuracy, all information should be verified.