Table 4 Reasons to refer a patient to secondary care, when the referral reason is known
From: Type 2 diabetes and COPD: treatment in the right healthcare setting? An observational study
| Diabetes Mellitus type 2 | COPD |
|---|---|
| Insufficient glycosylated hemoglobin regulation | Dyspnea (on exertion) |
| T2DM in combination with pregnancy wish | Coughing |
| Patient wishes a sensor indicator/ insulin pump/ glucose flash monitoring | Exacerbation of COPD |
| Diagnostic uncertainty on type 2 diabetes | COPD ‘The Global Initiative for Chronic Obstructive Lung Disease’ stage 3 or 4 (fitting with FEV1% < 50%) |
| Starting with a glucagon-like peptide-1 agonist | Pneumonia combined with COPD |
| Side effects of the medication | Insufficient treatment with the current medication |
| Elevated albumin/creatinine ratio in the urine (for advice) | Inconclusive spirometry |
| Neuropathic pain | Both obstructive and restrictive lung disease |
| Patient wishes a referral | Patient wishes a referral |
| The need for a new referral to secondary care (patient went to secondary care in the past) | Diagnostic uncertainty ons COPD |
| Hypoglycemia | Both COPD and asthma |
| Macrovascular complications | High burden of disease |