Diabetic Circulation screen

The Diabetic Circulation Risk Screen is a targeted screening program designed to assess circulation health in diabetics, identifying risks for complications like neuropathy and vascular diseases that lead to amputations. The screen includes:

Comprehensive Diabetic arterial assessment
A standard Diabetic foot screen
Personalized Amputation Risk Reduction plan

Diabetics are at a high risk of developing calcium and cholesterol deposits in their arteries all over the body. Sadly, it is the nature of the disease. Good sugar control helps, but blockages still develop. This leads to heart attacks, strokes, kidney failure needing dialysis and decreased blood flow to the limbs with possible amputations.

Our Diabetic Circulation screen is designed to help identify the risks of these complications early, and help you manage these risks to try to avoid both procedures and complications in the future.

Who is this screen for?

If you have been diagnosed with diabetes, or already are on medication for diabetes or have been found to have a HbA1C (Glycated haemoglobin – a measure of average blood sugar control over the last 2-3 months) of over 5.7%, this screening program is for you.

What tests does this screen contain?

Nurse assessment

For body composition measurements, BP, risk factor and medication record.

Urine test

For blood cells, sugar and protein.

Blood tests

Full blood count – low haemoglobin levels affect the ability of the circulation to carry oxygen; high white cell counts can signify infection, which is common in diabetics
Blood sugar and HbA1C
Kidney function – diabetes can cause kidney failure from a variety of circulation-related mechanisms.
Liver function – diabetes can cause a fatty liver.
Lipid (cholesterol) profile and thyroid function – diabetes can cause significant abnormalities in lipid control, especially if there is co-existing poor thyroid function.
hs-CRP – The high-sensitivity C-reactive protein (hs-CRP) test is a protein that measures general levels of inflammation in your body. The hs-CRP can be used to find the risk for heart disease and stroke in people who don’t already have heart or arterial disease.

Diabetic foot screen

Assessment for biomechanical change – nail infection/fungal infection, callus formation and changes in the shape of the feet and toes that increase the risk of amputation.
Assessment of loss of sensation across the foot
Ankle and toe pressures and Ankle-brachial index – measures drop in pressure in the feet compared to the arm, that can indicate critical decreases in blood flow.

ECG

Carotid intima media thickness

This is measured by ultrasound and is an overall measure of the risk of having an adverse cardiovascular event.

Peripheral Arterial Hemodynamic study

A non-invasive assessment of the blood pressure and doppler wave forms of the arteries at various levels in both the legs, to determine the presence and location of any narrowing or blockages in the legs from cholesterol and/or calcium deposits which may need further investigation or treatment.

Consultation with a senior specialist vascular surgeon

To discuss results and develop a plan to reduce risk of amputations and prevent circulation complications from diabetes.

Diabetic eye screening is NOT included in our package. If you wish, however, we can refer you to a specialist eye clinic for this. It is also advisable for diabetics to have regular eye check-ups.

How do I prepare for this screen and how long does it take?

If you have booked this screen, you should have received instructions on what to expect via email or phone. If not, please call the clinic at least 1 day before the screen at +65 64720503 during working hours to confirm the instructions.
The screen is conducted over 2 days. Plan about 5 hours in the clinic on the first day and about 1 hour on the second day.
You will need to come in the morning on Day 1 having fasted (without having had anything to eat) for at least 6 hours. You may have clear non-sugary drinks, black coffee or black tea.
Please DO NOT take your diabetic medication on the morning of Day 1, but you should bring the medication with you. You must, however, take any other medication you take for blood pressure or blood thinners etc with water as normal.
Wear comfortable loose clothing and shoes for the first day. A T-shirt and shorts or track bottoms are ideal.

What can I expect on the screening days?

On Day 1 of the screen, you will first be registered for the screening.
You will then be asked to provide a mid-stream urine sample and have your blood tests as you are fasting.
You may then go and have breakfast and return to the clinic, where you will have the nurse assessment and can have your diabetic medication as well.
All remaining tests will be done after that and should usually be completed on Day 1. Day 1 may need 4-5 hours to complete.
On Day 2 (which can be scheduled to your convenience but would be at least 3 days after Day 1 to allow for all test results to come back in), you will see the specialist vascular surgeon for a consultation and discussion. Day 2 may need up to 1 hour to complete. Please eat and take medications as normal on Day 2.

What if my screening detects a problem?

We will give you a detailed report and recommendations in writing to take away.
If screening results suggest you need further investigations or treatment, you will also be given a note for you to show your family doctor to make a formal referral to us. Further treatments or tests may not be covered by insurance if there is not a formal referral.
Your screening results and reports are NOT shared by us with your doctor or any third party including your insurers or employers. Sharing your report results with other doctors, insurers or employers is for you to do as you deem fit but is recommended.
We can also refer you for regular podiatry (diabetic foot care) and diabetic eye check-ups if you wish. Regular foot care is recommended to treat ingrown nails, corns or calluses and fungal foot infections to prevent complications of diabetic foot infection and ulceration.

How often is a Diabetic Circulation Screen needed?

Diabetic cardiovascular disease can progress with the duration of diabetes.
We recommend that you have this comprehensive screen every 2 years or so, to ensure that your circulation stays healthy, and any progression of disease is detected early.
We recommend the standard Diabetic Foot screening in the interval period on a 3, 6 or 12 monthly basis depending on disease severity.

you are covered

We are on the panel with most insurers in Singapore and with many international insurers; We also offer convenient options for self-paying patients.