Exclusion Criteria

Please do not refer patients with the following conditions:

• Type 1 Diabetes Mellitus
• Latent Autoimmune Diabetes in Adults (LADA)
• Maturity-Onset Diabetes of the Young (MODY)
• Gestational or pre-conception diabetes care
• Patients being referred for weight loss alone
• Advanced diabetes complications requiring tertiary care (e.g., active foot ulcers, dialysis-dependent CKD, gastroparesis)
• Incretin mimetic (GLP-1RA) initiation unless used as add-on therapy, in line with NICE NG28 guidance

Referral Requirements

All referrals must include the following:

• Essential Investigations (within past 2 months):
• Reason for referral
• HbA1c
• U&Es including eGFR
• LFTs
• Lipid profile
• Full Blood Count
• Urine ACR
• Supporting Information:
• Up-to-date medication list and allergies
• Recent clinic consultation notes or summary
•  Any previous diabetes education undertaken (e.g., DESMOND)
• Past insulin or injectable therapy history (if applicable)
• Relevant comorbidities (e.g., cardiovascular disease, CKD stage)

Additional Notes

GLP-1 receptor agonists will only be initiated as per national guidelines: generally in patients with a BMI ≥35 kg/m², or BMI <35 where weight loss would benefit comorbidities, and where triple oral therapy has failed or is not tolerated.

The service does not provide obesity management outside the context of T2DM.

Patients must be willing and able to engage with the service and commit to follow-up.

We do not keep patients on our list, once management plans have been set in place.

How to Refer

Referrals should be made by email using the NELFT SPA form. Incomplete referrals (e.g., missing bloods or history) may be returned to the referrer.