Procedure: The payment of pathology to exclude type 2 diabetes
To streamline entry into a Life! course or telephone health coaching (THC), Diabetes Australia – Victoria can purchase the pathology required to exclude diabetes and measure baseline lipids on behalf of eligible* potential participants.
Facilitators and providers can order these pathology slips from DA–Vic for the same purpose.
Please email Tristan Sherer, Life! Data Support & Referral Officer (DS&RO) at: tsherer@diabetesvic.org.au.
The procedure below sets out the steps involved in this process, you can also download a copy of this procedure.
An eligible potential participant expresses interest in taking part in a Life! course or THC through community risk testing or social marketing.
If the eligible potential participant has not had their fasting blood glucose tested in the previous 12 months they are offered to have the pathology required for entry paid by DA–Vic.
If the eligible potential participant accepts the offer, a pathology request slip is supplied with instructions on required fasting times. The facilitator will ascertain the eligible potential participant’s GP’s details and nominate that GP on the slip prior to supplying the path test. The eligible potential participant is also notified that the nominated Life! program health professional at DA–Vic will receive a copy of their pathology results.
The facilitator notifies the eligible potential participant’s GP in writing that the tests will be carried out for the purposes of enrolment in a Life! course or THC. The facilitator also notifies the DS&RO, in writing or via email, with details of the client(s) to expect pathology results from.
If the pathology request slip has been supplied as part of a first visit** the eligible potential participant can be added to the facilitator database and enrolled in a course or THC. The pathology tests are performed. The nominated GP and Life! program health professional receive the test results.
The nominated Life! program health professional reviews the individual results to ascertain whether diabetes can be excluded.
The DA-Vic DS&RO enters test results and the date received into the pathology database and contacts the facilitator to clarify eligibility status (see below):
Diabetes excluded:
The DS&RO forwards copies of the results to the facilitator. If the eligible potential participant took part in a first visit the facilitator updates their record in the facilitator database and notifies the eligible potential participant of their eligibility to continue the course or THC.
If the eligible potential participant has not yet been enrolled the facilitator may now notify them of their eligibility, offer them upcoming courses or THC and enter their details in the facilitator database.
Should the eligible potential participant elect not to enrol the facilitator will notify the DS&RO.
Diabetes not excluded:
If the eligible potential participant returns an FBG result in a range which prevents the nominated Life! program health professional from excluding diabetes, the facilitator will offer that participant an OGTT.
If the eligible potential participant accepts the procedure will continue from point 3 above. If the eligible potential participant rejects the facilitator will notify the DS&RO.
Diabetes diagnosis:
The DS&RO contacts the eligible potential participant and encourages them to make an appointment with their GP to discuss the results, if they have not already done so.
The DS&RO sends a letter to the nominated GP to advise of the test result and that the eligible potential participant has been contacted and encouraged to make an appointment with the GP.
The eligible potential participant will be contacted by Central Referral staff every two weeks until they have seen their GP. If after two calls they have not seen their GP, the response will be escalated to a nurse or health professional employed by DA–Vic.
First visit participants:
If a first visit participant who has commenced session 1 is newly diagnosed with type 2 diabetes they are permitted to continue the course. However, the facilitator should advise them of any other courses or programs which may be suitable following their diagnosis.
If a first visit participant who has not yet commenced session 1 is newly diagnosed with type 2 diabetes they are subject to the usual eligibility criteria and are ineligible for the Life! course. In this instance the facilitator should recommend other courses or programs which may be suitable following their diagnosis.
If the pathology test is not carried out:
If, after four weeks from the issuing of the pathology slip, no results have been received, the facilitator should contact the eligible potential participant to find out if they have been to a pathology appointment.
If they have, the procedure will continue from point 6 above.
If an appointment has not been attended, the facilitator should encourage the eligible potential participant to attend a pathology appointment and will reinforce the seriousness of diabetes and the effectiveness of the Life! course and THC. For first visit participants, diabetes status needs to be ascertained before session 5 for payment.
If no result is received within an additional four weeks, the facilitator should contact the individual again. If an appointment has been made or attended, the procedure will continue from point 6 above.
If a pathology appointment has not been attended, the eligible potential participant should be notified that they can contact 13 RISK at any time for support to enter a Life! course or THC, or to obtain further information on diabetes prevention.
Privacy requirements:
All pathology results will be kept in a locked filing cabinet for a period of seven years. Only authorised staff will have access to these results, namely the DS&RO and the director of the Life! program.
Pathology procedure
* Eligible for the purposes of this policy refers to:
Victorians aged 50 years or above at high risk of type 2 diabetes (AUSDRISK score 12+)
Aboriginal Victorians aged 18 years or above at high risk of type 2 diabetes (AUSDRISK score 12+)
Victorians aged 18 years or above with pre-existing cardio vascular disease
Victorians aged 18 years or above who have been diagnosed with gestational diabetes mellitus
who confirm that they do not have diabetes.
** First visit for the purposes of this policy refers to the process laid down by the Life! first visit procedure.