We like to think so. Our aim is to provide support and encouragement, along with education and training to all of our patients who live with diabetes. We would be interested in your views as to how we are doing. Use the feedback form or the on-line clinic to let us know your experiences?

There is a simple answer to this question -- YES! Those of us with diabetes are at increased risk of flu-related complications and it is not worth the risk. Those with diabetes are all offered flu vaccination and for good reason. Speak to your GP or practice nurse if concerned.

This is a well recognised situation. It is known as post-prandial hyperglycaemia - good pre-breakfast or reasonable pre-meal sugars but then marked rises in blood sugar after eating. The medication you are taking is not great at dealing with this situation. There are drugs that are better in helping your pancreas secrete enough insulin to prevent these large rises in blood sugars. Nateglinide and gliclazide might help. If however your HbA1c is very high it might be an indication that insulin therapy might be the only solution to this problem and to bring better control. Speak to your GP or diabetes team. This is a situation which needs sorted as these rises in sugar level will lead to poor overall diabetes control and have been specifically linked to an increased risk of developing complications in the future.

It is hard to comment on this. If you have never had an abnormal ACR before then this could be an error. On the other hand your ACR can jump up if you have a urinary infection at the time of collecting the sample. A one-off increase is not too worrying. If your ACR remains up on a number of occasions then this is more signifianct. If you want to send us an e-mail using the On-line Clinic function on the website and include your hospital number we can check this for you.

Don't think so. Being short of breath especially on hills and having sore legs when walking are more like signs of underlying diabetes complications rather than effects of any of the drugs you are taking. It would be good to speak to your diabetes team or GP and get a check up. You may be experiencing angina or claudication - problems due to reduced blood flow to your heart muscle and leg muscles when you exert yourself. On the other hand there are some diabetes and blood pressure tablets (glitazones, beta-blockers) that might be making these symptoms a little worse so again a check up would be helpful. It could be a combination of factors.

ACR stands for albumin creatinine ratio. This is a test carried out on the urine sample you bring to your clinic appointment. It measures how much protein is in your urine. It is a very sensitive test and can pick up very small amounts of protein. When you have diabetes you do not want to have protein in your urine as this is an early sign of kidney damage. The ACR level should be less than 3.0 . If it is less than 3.0 consistently then you have no signs of kidney stress or disease. Anything higher than 3.0 means you have microalbuminuria and your diabetes team or GP will want to discuss this with you and will recommend things you can do and treatment you can take to improve your kidney function and reduce the chances of longer term damage.

Absolutely. There is clear evidence that if we overeat and do not exercise regularly that our risk of developing diabetes increases really quite a lot. Even drinking 1-2 fizzy sugary drinks a day can increase the risk by 25%! So stop eating up all the left-overs!

This is a good question. There are very powerful drugs known as statins which are helpful in reducing cholesterol levels in those with diabetes. Reducing your cholesterol leves helps reduce your risk of heart disease in the longer term. However, if you are young with well controlled diabetes, a normal blood pressure and are not overweight or a smoker there may not be any real advantage in taking these drugs just now as your risk of getting heart disease is not really high enough for you to tqake medication. You could wait until you are a little older (around 40-45 years of age) before starting a statin. Speak to your diabetes team and have a good discussion about your individual risk and what should be done to reduce it.

Gestional diabetes is a form of diabetes that appears or is diagnosed in women during pregnancy - usually in the last third or trimester of the pregnancy. Pregnancy puts extra demands on insulin production and if these demands cannot be met then diabetes develops. Gestational diabetes usually goes away when the baby is born. You will have a glucose tolerance test carried out about 6 weeks after your baby is born to check.