Diabetes Mellitus


If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

Pancreatic disease

  • Diabetic ketoacidosis  - A
  • Diabetes and severe vomiting - A
  • Acute severe hyperglycaemia
  • Acute severe hypoglycaemia - A
  • Hyperosmolar hyperglycaemic state (HHS) - A
  • Newly diagnosed type 1 diabetes – B (call registrar or consultant on call)
  • Foot ulcer with infection and systemically unwell or febrile -A
  • Invasive infection or rapidly spreading cellulitis of the foot (defined by peripheral redness around the wound >2cm) -A
  • Acute foot ischaemia - A
  • Wet gangrene foot - A

Urgent cases – (refer to key below)
A – client to present to emergency department immediately
B – client to present to diabetes specialist service within 24 hours.  If no specialist service is available, present to an emergency department.

High Risk Foot

  • Foot ulcer with infection and systemically unwell or febrile
  • Invasive infection or rapidly spreading cellulitis (defined by peripheral redness around the wound >2cm)
  • Acute ischaemia
  • Wet gangrene
  • Acute or suspected Charcot
Useful Management Information
  • Refer to local Healthpathways or local guidelines
  • For chronic disease management consider GPMP/TCA management plan

For management in primary care:

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1
(appointment within 30 calendar days)

If you feel your patient meets Category 1 criteria, please mark "urgent" on your referral

  • Pregnancy in patient with existing diabetes. For optimum care, patient should be seen within 1 week
  • Newly diagnosed GDM. For optimum care, patient should be seen within 1 week
  • Poorly controlled diabetes with recent deterioration despite escalation of therapy (HbA1c >86mmol/mol or 10%)
  • Major hypoglycaemia episode (assistance has been required by a third party) or problematic or multiple episodes of hypoglycaemia.
  • Existing type 1 diabetes with newly diagnosed coeliac disease
  • Existing diabetes with recent unintentional weight loss (> 5% of body weight over a month period)
  • Diabetes requiring optimisation in the presence of severe vascular complications, for example stage 3 CKD, proliferative retinopathy, gastroparesis
  • Diabetes with disordered eating
  • Diabetic foot ulcer – refer to high-risk foot criteria
  • Post DKA admission. For optimum care, face to face or telephone review should be seen within 1 week.
Category 2
(appointment within 90 calendar days)

*The following category 2 cases can be referred to local/regional general physician if endocrinologist access is not locally available.

  • Diabetes requiring optimisation in the presence of uncontrolled risk factors for chronic vascular disease (CVD)*
  • Unsatisfactorily controlled diabetes with recent deterioration despite escalation of therapy (HbA1c 64-86mmol/mol or 8-10%)*
  • High-risk (but currently not ulcerated) foot in client with diabetes*
  • Pre-pregnancy planning
  • Private or commercial driver’s licence who require a new or renewal of conditional licence
  • Stable type 1 diabetes
  • For consideration or commencement of continuous glucose monitoring or continuous subcutaneous insulin infusion pump
Category 3
(appointment within 365 calendar days)
  • Self-management education or difficulties in managing diabetes in the absence of adequate community resources

If your patient does not meet the minimum referral criteria

  • Consider other treatment pathways or an alternative diagnosis
  • If you still need to refer your patient:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
    • Please note that your referral may not be accepted or may be redirected to another service
Standard Referral Criteria

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Relevant clinical information about the condition

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g. tracheostomy in place, oxygen required)
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

Reason for request

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

Clinical modifiers

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Other relevant information

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc

Essential referral information

Without this information the referral will be returned

  • Type of diabetes and duration of disease
  • Details of all treatments offered and efficacy
  • Medication history
  • Presence of any complications and details when screening last performed
  • Height, weight, BMI
  • BP
  • History of smoking
  • HbA1c (current and previous)
  • FBC ELFT fasting lipids – cholesterol LDL HDL Tg
  • Urine albumin: creatinine
Additional Referral Information
  • Copy of GPMP/TCA
  • Ankle brachial pressure index (ABPI)
  • Licence status
  • Results of depression screening (PHQ-2)
    • over the last 2 weeks, how often have you been bothered by any of the following problems?
      • little interest or pleasure in doing things?
      • feeling down, depressed, or hopeless?
  • If Type 1 diabetes: TSH, anti-transglutaminase antibodies, IgA for coeliac disease within the last 5 years
  • If peripheral neuropathy: B12 folate
Clinical Override

Clinical override of referral criteria may be requested in the following situations:

  • Inability to include essential referral information. If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons.
  • Patient does not meet minimum referral criteria. If the patient does not meet the criteria for referral but the referring practitioner believes that the patient requires specialist review.
  • Presence of clinical modifiers. The presence of clinical modifiers (as listed above in Standard referral information) may impact on the categorisation of a patient.

Include the reason for request for clinical override as part of the referral. Referrals are reviewed by the triaging specialist who determines the most appropriate course of action.

Out of catchment

West Moreton Health is responsible for providing a public health service to people who reside within its catchment area. To appropriately manage demand for service we do not accept referrals from outside this catchment area. If your patient does live outside the West Moreton Health area and it is deemed socially or clinically necessary for their care to be received in the West Moreton Health Service, inclusion of information regarding their particular medical and/or social factors will assist with the triaging of your referral.


To provide feedback about contents on this website or general referral questions please email WM-CPC@health.qld.gov.au or phone 3413 7402.