Clinic appointments at the Leeds General Infirmary

Children

The children's clinics are held in the Children's Outpatient Department in the Clarendon Wing on a Tuesday morning.  (The Children's Outpatient Department is run by Sister Sandra Garbutt).  The children are split into three age groups 0-7 years, 7-10 years and 11-14 years.

At the appointment you will either see Dr Holland or his Senior Registrar.  You will see Wendy, Julie or Mel as well as Frances.  You will have your height and weight measured at each visit.  We ask the children to provide a blood specimen from a finger prick for the HbA1c test about two weeks before each appointment.  We aim to help you to achieve a HbA1c of 7.5%.  We can then have the result before your appointment to discuss any changes that may need to be made.

At the beginning of the year, you will be given four appointments.  Two of these are routine clinic appointments.  One of them will be an Annual Review where you will be asked to provide a urine specimen and have your blood pressure checked.  You may need to have a blood test to screen for coeliac disease or thyroid conditions, or to check other blood levels (e.g. cholesterol).  This will be discussed with you first.

The other appointment may be an Activity Clinic.  On these days we ask all the children to spend the morning with Wendy, Julie, Mel and Frances playing games and learning more about diabetes.  The parents spend the morning with Dr Holland, Alistair Duff and one of the Diabetes Nurses discussing issues which we have found may be relevant for that particular age group.  Most of the children and parents who have attended these Activity Clinics have found them to be very beneficial.  They provide an opportunity to meet other children with diabetes of a similar age and to learn through play.

If you are unable to attend any of your appointments, please telephone on 0113 3926793 to arrange an alternative appointment.

Adolescents

When you are around 14 years of age, you will be transferred to the Adolescent Clinic.  This is held in the Diabetes Centre at Leeds General Infirmary on the first Wednesday of each month from 2.00-4.30pm.  It is run at the same time as the Young Adult Clinic held by Dr Ramzi Ajjan, the Adult Diabetologist.

You will meet the staff at the Diabetes Centre, including the Diabetes Nurse Specialist for Young Adults, the Health Care Assistant and the Receptionist.  You will see Julie and Mel and you will see either Dr Holland or a Senior Registrar.  You will see the doctors on your own, before your parents are invited in.  This is to encourage independence and allow privacy.

We ask you to send in a Hba1c sample about 2 weeks before each appointment, as you did before.

You will be seen at least every 3 months, but we may ask you to attend more frequently.  Adolescence is a difficult time and the effects of growth hormone mean that it is difficult to achieve good control of blood glucose.  You will need to increase your insulin dose quite often whilst you are growing rapidly.  The Receptionist will make your next appointment as you are leaving.

It is very important not to start smoking, as the combination of diabetes and smoking leads to an increase in the risk of heart disease.  We are registered Smoking Cessation Advisors with the Leeds Smoking Services and can advise people with diabetes who do smoke.  We will discuss alcohol, drugs and sex with you and can advise on careers, driving, leaving home etc.  You can also look these subjects up on the Teenage Web site.

You will be screened for any early signs of complications of diabetes by having your urine, blood pressure and eyes checked.  We do not expect to find any problems, but if any are found, the right treatment can begin straightaway.

Young Adults

When you are 16-17 years of age, you will be transferred to the care of Dr Ramzi Ajjan in the Young Adult Clinic.  The age at which you are transferred depends on various factors including the age at which you leave school and how well your diabetes is controlled.

To prepare for transfer you will be invited to attend a Transition Clinic with your Diabetes Nurse and Dietitian, where you will meet the Diabetes Nurse Specialist for Young Adults.  As well as discussing relevant aspects of your diabetes care, we will discuss the Adult Diabetes Service and how this may differ from the Children's Service.

You will attend the Young Adult Clinic which is run alongside the Adolescent Clinic and will see Dr Ramzi Ajjan on your own.  Any blood tests will be performed at the hospital.  You will be seen by the Diabetes Nurse Specialist for Young Adults.

Because you are now an adult, you are responsible for your own diabetes management.  If you cannot attend an appointment, you must telephone to rearrange it.  If you fail to attend your clinic appointment, you will be discharged and will need to be referred from your GP if you wish to be seen again.