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Screening / Wellness Clinic

At our nurse led clinics a variety of basic checks can be done. Advice on general health screening can also be accessed if needed; Some of our specific services include:

Every person over the age of 35 years (and younger in the presence of significant risk factors) should screen for the presence of prediabetes and diabetes (American Diabetes Association).

Early in its course diabetes and diabetes may have no symptoms at all. Regular screening is key to preventing early onset of diabetes related complications and gives you the best chance of putting the condition in remission or maintaining tight control; which increases chances of stopping or slowing down the course of Type 2 Diabetes (if remission is not possible).

Most persons who have a diagnosis of Type 1 Diabetes will present with significant symptoms.

Elevated blood pressure is very common in the population (about 40% of Barbadian adults) and even much more common in those at risk of or living with diabetes. Blood pressure checks are done at all screening and medical visits.

We encourage you to know your targets and if you monitor your blood pressure at home to bring your machine to each visit. Direction on checking the blood pressure correctly will be given.

HEARTS in the Americas: Bloo d Pressure Measurement – PAHO/WHO Pan American Health Organization

Elevated blood pressure is very common in the population (about 40% of Barbadian adults) and even much more common in those at risk of or living with diabetes. Blood pressure checks are done at all screening and medical visits.

We encourage you to know your targets and if you monitor your blood pressure at home to bring your machine to each visit. Direction on checking the blood pressure correctly will be given.

All adults and persons living with diabetes or hypertension should have at least annual kidney screening and more frequent checks if indicated.

Testing consists of a combination of urine protein testing (urine microabulin and albumin to creatine ratio) and blood testing of the creatinine and glomerular filtration rate.

The results put the kidney function in a range described by KDIGO – KIDNEY DISEASE | IMPROVING GLOBAL OUTCOMES.

The National Kidney Foundation Website provides simple information to learn more about kidney disease.

EKGs are recommended to be performed annually on middle-aged or elderly people who have heart attack risk factors such as high blood pressure, low cholesterol, or diabetes, or a strong family history of heart disease.

If your risk is low, discuss with your care provider how often you should be having this screening.

All persons living with diabetes should have access to a monitoring device to check the blood glucose measurements. Our team can discuss the different monitoring options.

Learning how often and when to test for the information, helps you and the healthcare provider control your blood sugar levels. Testing only in the morning (fasting) often does not provide the information needed when done in isolation.

CGM is a new way of monitoring the glucose levels in the body using a sensor that is attached to the skin which can be read by a special reading device or possibly linked to your phone.

CGM often covers Flash Monitoring (Freestyle Libre Flash Monitoring) which is not truly continuous but measures levels only when checked. True CGM reads whether you are checking the glucose or not. It is important to understand how to interpret and use the information to make best use of this type of technology.

Medical Consultations

Our Medical Physicians are highly qualified and equipped to deal with your medical and diabetes specific needs as part of the multidisciplinary team and approach. A full medical, family and social history will be taken, followed by a physical examination and foot screening.

Not only will we aim to diagnose any issues with differentials, but we will explore perceived barriers to achieving goals and make a plan with you and guided by you based on agreed goals and anticipated outcomes for that visit.

Please always come to your visits with any home blood glucose or blood pressure monitoring devices, and a full list of your current medication including the doses and times of the day that you take it. If you have been referred by a care provider please bring any information they asked you to bring to the visit.

Our team of physicians and nurses are always on hand to direct you to what services will best meet your specific needs.

Education & Diabetes Specialist Nurse Services

Learn more about your risk of Diabetes and other related NCDs (noncommunicable diseases). Have you or a loved one had a recent diagnosis of prediabetes or diabetes?

Need assistance with getting your blood glucose(“sugars”) to target

Living with Type 1 Diabetes

Unsure about your medication timing

Experiencing high and low blood sugars

Taking Insulin

Experiencing some dramatic life change

Suffering from Diabetes Distress

Require specific attention or advice e.g. shift worker, athlete, elderly relative etc

Need information or education on CGM (continuous glucose monitoring) or Flash Monitoring

EVERY person LIVING with Diabetes or Prediabetes Requires ANNUAL Self Management Education (ADA)

Our Diabetes nurses are specially trained to provide general education on diabetes and diabetes prevention, along with coping skills and more specific information related to Medication, Insulin Training & Management, Carbohydrate Counting, Diabetes Distress Management.

Association of Diabetes Care and Education Specialists (ADCES)
We believe everyone deserves to “live their best life!”

Nutrition & Weight Management

Don’t Know What to Eat?
Feeling overwhelmed by food choices? If you’re constantly asking, “Is this healthy for me?” it’s time to work with a Dietitian. Together, we’ll conquer food fears and help you confidently plan balanced meals.

Weight Loss for Diabetes Remission!
Achieving diabetes remission means returning blood sugar levels to a safe range without medication.
While not everyone can achieve remission, it is possible for some, especially with immediate action.

Weight loss can be a key factor. Partner with a Dietitian to create meal plans that avoid blood sugar spikes and promote sustainable weight loss, aiming for diabetes remission.

Lose Weight and Keep It Off!
Tired of “yo-yo dieting”? This frustrating cycle often results from unsustainable weight loss methods. Instead of another fad diet, work with a Dietitian to learn lifelong strategies for healthy weight loss, whether you have diabetes or not

The nutrition services are designed to meet both general and specific NCD needs.

We consider your likes/dislikes and lifestyle then work with you to enhance your knowledge and ability to make better choices that will work for you.

Our department caters to pediatric weight and diabetes education.
Often your care provider will refer you if they think you can benefit from this service.

Just as you & your lifestyle are unique, nutrition planning can also be unique for persons living with diabetes. Good nutrition habits should never leave you feeling bored, frustrated or deprived.

However, in order to manage diabetes well there are certain changes you may have to make. Nutrition choices and Lifestyle behaviors are the foundation of Diabetes and NCD management.

Nutritional Considerations may be made for persons living with hypertension, high cholesterol or any other NCD or food preference plan. We are here to work with you.

Some persons may require a gluten free diet for health reasons such as Coeliac Disease or specific food allergies. Contact us for more information.

 

PCOS is closely linked to diabetes and nutrition plays an important role in the management of PCOS and of course the insulin resistance associated with it. A healthy diet, regular activity, and quality sleep can help reduce symptoms and better manage the side effects of PCOS.

Learn about strategies, how to make food exchanges and develop the flexibility and expertise on how to eat better. If you wish a specific meal plan, you may discuss your options with our registered dietician.

There are many ways of doing carbohydrate estimates or formal counting. If you are living with diabetes, and or using insulin or living with Type 1 Diabetes you will benefit greatly from understanding and applying some form of carbohydrate estimations or counting.
Being at a healthy weight is important especially if you’re living with Diabetes. If you are overweight, losing even 5-10% of your body weight can help you manage your blood sugars better. Our registered dietician can help you do this.

Intermittent fasting has been shown to be a powerful tool in the management and remission of diabetes as well as other chronic conditions. It is also effective for weight reduction.

If you would like to learn more about this simple, effective and affordable nutrition tool please ask any member of our health care team.

There are many “diet” options available to you. What works, is what works for you.

In person or virtual nutrition workshops, seminars & presentations can be planned for your specific small group. Call us today to learn more about this service and plan your session.

We provide Nutrition Education and advice forall ages and lifestyles tailored to suit your needs.

Cardiology Consultations

This program is managed by Consultant Cardiologist Dr Aderemi Soyombo (Healthy Heart Inc.) who is charge of cardiology at the centre. Did you know that cardiovascular disease is the leading cause of premature sickness and mortality in persons living with Diabetes, Hypertension, Cholesterol Disorders and those with a significant smoking history? Therefore, early diagnosis is critical as is optimal appropriate investigation and management.

Our cardiology services are available to the public with a referral from your primary care provider or another specialist. If you have not had a prior ECG, one will be performed at the visit.

Do you have concerns about your cardiac status?

Do you have an abnormal ECG?

Have you had a previous vascular event?

Are you having symptoms that make you wonder if you have a cardiac symptoms?

Vascular Screening

Screening for Peripheral Arterial Disease (PAD)a common complication of Diabetes and Hypertension and in smokers, which can put one at risk of limb loss. Interestingly African Americans and Caribbean people are at a higher risk of PAD as are persons living with diabetes. A complete history and consultation is taken to uncover any other issues related to the lower limb that may need further attention.
Who should have Vascular Screening

Age 65 years and older

Age 50 years and over living with Diabetes, Hypertension, Cholesterol Problems or having a family history of PAD

Age under 50 year with Diabetes for > 10 years

Long Term Smoker

Personal History or Family History Ischemic Heart Disease or Stroke

Eye Screening

Eye Screening is a painless procedure performed digitally and involves:

A General History and Eye History

Visual Acuity Check (reading the charts)

Digital Retinal Photographs

What else do we offer?

This essentially is used to examine the back of the eye in more detail and can be used to look for diseases of the Optic Nerve, Macula, and the Retina in greater detail
The pressure in the eyes can be measured painlessly with a tool called a Tonometer and if further testing is needed an OCT can be requested by the Eye Team.
Our Eye Screening services are available to the general public! Learn more here

Foot Clinic

In the foot clinic we deliver general foot and footwear education andprovide the following foot services.

This screening involves taking your history, examining your feet, and assessing your walking gait and your shoes.

The screening will look for evidence of changes to the skin nails joints, and nerve function and circulation. Education on proper care, follow up and foot wear is also delivered in this session.

The control of diabetes impacts the foot a lot and people coming for a foot screen should still always come with their medication list and blood glucose machine. Remember good regular care is the best way to go.

Do you have unusual changes to the skin or nails on your feet? Maybe dryness, cracking, discoloration, bruising under the nails, thickening or ingrown nails? An assessment can help to determine the causes and advice will be given after discussion.

Take care of your feet, they are the only feet you have!

CVI is very common, even more so as we get older.

The person may notice thread-like or varicose veins on the lower limbs and swelling, changes in skin color or even itching, discomfort and numbness. CVI should be properly managed after an assessment to reduce the risk of ulceration related to severe or longstanding CVI.

If you have difficulty doing your own nail care, are visually impaired or have a medium to high risk foot, or other nail issues, a trained health care professional may be the best person to assist you with your nail care.

These are hard and thickened areas on the foot, which reflect areas where the foot is experiencing high pressures. This could be due to footwear (past or present), foot shape, previous injury or surgical procedure and walking barefoot.

Callus and Corns should be managed properly because of the risk of causing internal bruising and injury to the foot which can end in an ulceration. If you ever notice a change in the color of the callus seek immediate care. We advise regular management and proper footwear to reduce the risk of complications.

Wound Care Clinic

Our team specializes in providing expert care for diabetic wounds, recognizing the importance of prompt and effective treatment for those living with diabetes. Due to the slower healing process in persons living with diabetes, nerve injury, or vein or artery insufficiency, it’s critical to address wounds with urgency.

Please be aware that puncture wounds are treated as a surgical emergency requiring immediate surgical review. Punctures may imbed dirt and bacteria deep into the flesh or along what we call the “ puncture track”. This process can easily cause an infection which if not treated properly may quickly become a major problem and increase the risk of amputation.

All wounds showing signs of infection require immediate attention to avoid serious complications.

In Barbados, more than 300 amputations are performed annually due to complications from wounds. However, you don’t have to be part of this statistic. Avoid attempting to manage wound care on your own and do not delay seeking professional help.

Remedial Therapy & Massage

Sessions to target specific needs are available by request, following a brief interview to identify what treatments will most meet your needs. The service is currently under further development.