|
|
The mission of the Diabetes HMP is to improve the overall diabetic control and reduce the incidence of diabetic complications, thereby reduce the personal and social burden of diabetes.
Diabetes Health Management Programmes and GPs
In an attempt to facilitate clinical integration and support practice according to MOH Clinical Practice Guidelines, the flowchart below has been developed to summarise the recommended process guidelines (frequencies of investigations, screening and education etc.) |
|
Overview of the Management of Individuals with Confirmed Type 2 Diabetes Mellitus
|
|
SingHealth Resources for Your Patients
Diabetic Retinal Photography
- SingHealth Polyclinics
(No consultation – Photo & report will be given to the patient to take back to the referring GP).
- SNEC Enhanced Diabetic Retinopathy (EDR) Care Ophthalmic
Photography Service
(No consultation – Photo & report with recommendations for further management will be sent to the referring GP by post or e-mail).
- CGH Full Assessment Clinic (Annual)
(Report will be given to the patient to take back to the referring GP. Patients will also be scheduled to return a year thereafter for re-screening).
Ophthalmic Consultation / Counselling and Patient Education
- SNEC EDR Care
Weight Management Programme
Obesity Management Programme at the SGH LIFE Centre
- Comprehensive Obesity Management
(Each programme comprises of 5 consultations with the doctor and clinical co-coordinator, 6 sessions with the dietician, including a supermarket tour and cooking class, 11 sessions under the supervision of trained physiotherapists, and 2 sessions of behavioural modification with the psychologist).
Activity-based Obesity Management
(Each programme comprises of 18 sessions of aerobic, stretching and strength training exercises three times per week under the supervision of trained physiotherapists).
Dietary Obesity Management
(Each programme comprises of 6 sessions with the dietician, including a supermarket tour and cooking class)
CGH Weight Loss Programme
(Each programme comprises of 11 sessions of exercise under the supervision of trained physiotherapists, 3 consultations with a doctor and 4 consultations with a dietitian
KKH Endocrinology Services Clinic
(for Children whose weight are 160% to 170% or more of their ideal body weight)
Diabetic Foot Screening (DFS)
- SingHealth Polyclinics
(No consultation, screening will be performed by nurses trained specially to perform DFS – A report will be given to the patient to take back to the referring GP).
- CGH Full Assessment Clinic (Annual)
(Report will be given to the patient to take back to the referring GP. Patients will also be scheduled to return a year thereafter for re-screening).
Dental Check-up
- Bedok, Geylang and Queenstown Polyclinics
- National Dental Centre
Diet
Education
- CGH Full Assessment Clinic (Annual)
(Report will be given to the patient to take back to the referring GP. Patients will also be scheduled to return a year thereafter for re-screening).
Medical Nutrition Therapy
- SGH Dietitian's Clinic at Rm. 13, L Clinic
(Services include Nutritional Assessment, Diet assessment, Counselling & Individualised Meal Plan. A report for each visit will be given to the referring GP. Please provide a memo with medical history, type of medications, latest relevant blood test results and type of diet required e.g. cholesterol-lowering, weight reduction)
For any of the services, please contact the respective institutions' Central Appointments Call Centre
-------------------------------------------------------------------------------------------------------------------------------------The Delivering on Target (DOT) Programme
About Delivering on Target (DOT)
The SingHealth Delivering On Target (DOT) programme is a model for community-based chronic disease management in a local context. DOT aims to create closer links between GPs and the tertiary care institutions to enable the management of suitable patients from the hospitals at the community level.
DOT Optimisation Programme
The DOT Optimisation Programme is a partnership between SingHealth, Johnson & Johnson Medical Singapore, and Diabetic Society of Singapore (DSS) to create a General Practitioner-Diabetes Educator team approach towards caring for patients with diabetes. The first phase comprises four CME sessions for GP’s and the second phase allows GPs to refer at least 5 patients to DSS for 3 free individualised Diabetes Education sessions per patient.
DOT Symposium
The DOT Symposium was organised to raise GPs’ awareness of the benefits of the DOT programme and provide continuing medical education in key aspects of chronic disease management. These are held at irregular intervals and include local and overseas experts sharing their experiences on managing chronic diseases.
Contacts
Assistant Programme Manager
Hilda Ng
Email: hilda.ng.s.h@singhealth.com.sg | | |
|