Referral criteria to diabetes dietetic service
The specialist diabetes dietetic service operates on a referral system; new referrals are accepted from
consultants, Diabetes Specialist Nurses, GPs, Practice Nurses and other AHP staff.
Referrals can be made by letter, fax or referral form. Some self-referral or treatment enquiries from patients are
accepted by email.
NB: it must be noted on the referral if the patient requires an advocate.
All newly diagnosed patients
 New type 2 patients preferably via the structured education programme (EDDI), if appropriate
 New type 2 patients who need advocacy (patients can be seen at Hackney Diabetes Centre or GP surgery, if
advocacy is available. Non-English speaking patients should not be referred to EDDI education groups
 New type 1 patients should always be referred for nutrition education and assessment within the
multidisciplinary specialist team
Review patients
People with diabetes who identify nutrition/lifestyle-related issues via the annual care planning process which
include:
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Any patient with an HbA1c greater than 7.5% (59mmol/mol)
Type 2 who are on maximum oral agents and require pre-insulin assessment
Type 2 where food and insulin are not matched, resulting in hypo/hyperglycaemia
Type 1 where food and insulin are not matched, resulting in hypo/hyperglycaemia
Type 1 patients who are about to initiate insulin pump therapy or established patients who need review
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Dyslipidaemia
o For those who are eligible for a statin, but wish to pursue lifestyle changes
o Type 2 under 40 years and Type 1
o Those treated with statins whose dyslipidaemia persists
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Hypertension
o For those who indicate that they wish to consider lifestyle changes via the care planning process
(e.g. weight management, salt reduction, alcohol)
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Obesity
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For those who indicate that they wish to consider lifestyle changes to promote weight reduction
When weight trend is upward
Planned surgery e.g., CABG, orthopaedic surgery, transplant
If anti-obesity drugs are to be considered
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Pregnancy / pre-pregnancy – in conjunction with diabetes pregnancy team
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Lifestyle changes such as changes to physical activity, moving away from home (for young type 1 patients)
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Renal disease CKD 1, 2, 3 (CKD 4 and 5 may be seeing specialist renal dietitian)
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Patients with an eating disorder or disordered eating
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Nutrition Support for undernourished diabetic patients requiring basic nutritional support e.g. post surgical,
cancer, coeliac, anaemia or pancreatitis
(If nutrition support rather than diabetes management is the primary reason for referral, it may be more
appropriate to refer to specialist nutrition support dietitian).
Incorporating hospital and community health services, teaching and research