assess whether there is a need to refer to a specialist service
• refer children and young people with signs/ symptoms of diabetes urgently on the same day to a specialist diabetes paediatric team for hospital admission and insulin therapy
•urgently refer adults who are unwell, who have ketones in their urine or a blood glucose level
> 25mmol/l to a specialist diabetes team for possible hospital admission and insulin therapy
• refer adults with diabetic ketoacidosis (DKA) or diabetic hyperosmolar non-ketotic syndrome
(HONK) for urgent hospital treatment
• refer adults under 30 with Type 2 to a specialist diabetes team for – in most cases – outpatient insulin therapy; some will also require urgent specialist care
•newly diagnosed people with none of the above symptoms should be managed within primary care

• explain the condition and its management, taking account of people’s emotional state and cultural/social background
•provide leaflets, audio/videocassettes and

information about Diabetes UK and local
Diabetes UK voluntary group
•discuss impact of the condition on work
• advise drivers to inform their insurance company and DVLA (if diabetes is going to require medical treatment) • advise people they are exempt from prescription charges for diabetes medication (if diabetes is going to require medical treatment).

Structured/systematic care is the means by which the person with diabetes and their healthcare team work together to prevent short-term and long-term complications. Events-related care refers to episodes of care that the person with diabetes may need at any time (at diagnosis, in the first y e a r, during continuing care) and which may require access to specialist practitioners not normally involved in their structured/systematic care. When such events-related care is necessary, it needs to be combined with the person’s structured/systematic care. When the episode of events-related care is complete, the person’s structured/systematic care continues as normal. Many episodes of events-related care will be short term, eg diabetic