Department of Health

Specialty: Endocrinology
Age group: Adult

Direct to an emergency department for:

  • Diabetic ketoacidosis or suspected diabetic ketoacidosis (e.g. abdominal pain, dehydration, confusion, nausea and vomiting)
  • Hyperosmolar hyperglycemic state
  • Diabetes and severe vomiting
  • Acute, severe hyperglycaemia
  • Acute, severe hypoglycaemia
  • Suspected Charcot’s neuroarthropathy (e.g. unilateral, red, hot, swollen, possibly aching foot)
  • Foot ulceration with absent pulses.

Immediately contact the endocrinology registrar to arrange an urgent endocrinology assessment for:

  • Pregnancy in known diabetic woman
  • Recent, resolved hypoglycaemia episode resulting in unconsciousness.

Criteria for referral to public hospital specialist clinic services

  • Type 2 diabetes not responding to a combination of dietary AND medical management (i.e. has tried at least three glucose-lowering medicines) with HbA1c greater than 64 millimoles per mole or 8 percent
  • Patients with type 2 diabetes with complications (e.g. cardiovascular disease, kidney disease, retinopathy, cerebral vascular disease, neuropathy)
  • Planning for pregnancy
  • Management of unstable glycaemic control due to concomitant use of medicines that impact on glycaemic control (e.g. corticosteroids, chemotherapy protocols)
  • Assessment for commercial driver’s licence
  • Diagnosis of type of diabetes.

Information to be included in the referral

Information that must be provided

  • Reason for referral.
  • All medicines previously tried, duration of trial and effect
  • Current and previous HbA1c results
  • Known complications or comorbidities (e.g. cardiovascular disease, kidney disease, retinopathy, cerebral vascular disease, nerve damage in the lower limbs, anxiety, depression, foot ulcers)
  • Current and complete medication history (including non-prescription medicines, herbs and supplements)
  • Urea and electrolyte results
  • Creatinine blood results
  • Albumin to creatinine ratio (ACR) urine results
  • Liver function results
  • Lipid profile results.
  • Functional impact of symptoms on daily activities including impact on work, study or carer role
  • If the person identifies as an Aboriginal and/or Torres Strait Islander
  • If the person is part of a vulnerable population.

Provide if available

Not applicable.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

Vulnerable populations include:

  • people from culturally and linguistically diverse backgrounds
  • older Australians
  • carers of people with chronic conditions
  • people experiencing socio-economic disadvantage
  • people living in remote, or rural and regional locations
  • people with a disability
  • people with mental illness
  • people who are, or have been, incarcerated.

Vulnerable patient groups also include: terminally ill patients, patients with experiences of family violence, in out-of-home care, foster care and those in state care.

Where appropriate and available, the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

  • Well controlled type 2 diabetes (responding to dietary and medical management with HbA1c less than 64 millimoles pers mol or 8 percent) without any complications or comorbidities
  • Patients being managed with dietary measures alone.

Reviewed 02 June 2025

Statewide Referral Criteria

Contact us

Address
50 Lonsdale Street
Melbourne, VIC 3000

Phone
1300 650 172
National Relay Service

Email
plannedcare@health.vic.gov.au

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