Documenting an endocrinology clinic
Clinic notes with sensor metrics and dose changes, results letters, and letters back to the referring GP.
An insulin review with two weeks of sensor data
Type 2, twelve years. Glargine 32 units at night, metformin 1 g BD, empagliflozin 25.
Fourteen days of CGM. Time in range 52%, above range 46%, below range 2%. GMI 7.9. HbA1c 8.4.
Fasting 9 to 11. The big rise is after the evening meal.
Glargine up to 36. Start semaglutide 0.25 weekly for four weeks, then 0.5, on a private script.
Dietitian review. Sensor download again in six weeks, HbA1c in three months.
Background
T2DM, 12 years. Glargine 32 U nocte, metformin 1 g BD, empagliflozin 25 mg daily.
CGM, 14 days
TIR (3.9 to 10.0) 52%. TAR 46%. TBR 2%. GMI 7.9%. HbA1c 8.4%.
Pattern
Fasting 9 to 11 mmol/L. Largest excursion after the evening meal.
Changes
- Glargine increased to 36 U nocte
- Semaglutide 0.25 mg weekly for 4 weeks, then 0.5 mg weekly (private script)
Plan
- Dietitian review
- CGM download in 6 weeks
- HbA1c in 3 months
Back to the referring practice
- Letter to the GP
- The sensor metrics against target, each dose change, the titration plan and the next review.
- Results letter
- For a thyroid, adrenal or bone result that changes management between visits.
