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'Referral advice' recommendation details

Type 2 diabetes (partially updated by CG87)

Guidance ID NICE 'referral advice' recommendation 'Referral advice' category
CG66 Agree referral criteria for specialist renal care between local diabetes specialists and nephrologists. Follow up
CG66 Arrange emergency review by an ophthalmologist for: - sudden loss of vision - rubeosis iridis - pre-retinal or vitreous haemorrhage - retinal detachment. Arrange rapid review by an ophthalmologist for new vessel formation. Refer to an ophthalmologist in accordance with the National Screening Committee criteria and timelines if any of these features is present: - referable maculopathy: - exudate or retinal thickening within one disc diameter of the centre of the fovea - circinate or group of exudates within the macula (the macula is defined here as a circle centred on the fovea, with a diameter the distance between the temporal border of the optic disc and the fovea) - any microaneurysm or haemorrhage within one disc diameter of the centre of the fovea, only if associated with deterioration of best visual acuity to 6/12 or worse. - referable pre-proliferative retinopathy (if cotton wool spots are present, look carefully for the following features, but cotton wool spots themselves do not define pre-proliferative retinopathy): - any venous beading - any venous loop or reduplication - any intraretinal microvascular abnormalities - multiple deep, round or blot haemorrhages - any unexplained drop in visual acuity. Follow up
CG66 If gastroparesis is suspected, consider referral to specialist services if: - the differential diagnosis is in doubt, or - persistent or severe vomiting occurs. Time frame not specified
CG66 Investigate unexplained discrepancies between HbA1c and other glucose measurements. Seek advice from a team with specialist expertise in diabetes or clinical biochemistry. Follow up

This page was last updated: 22 August 2012

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.