The SIR Clinic

Who is the SIR Clinic for?

The clinic is part of a highly specialised NHS service for both adults and children with known or suspected severe insulin resistance and/or lipodystrophy.

Before clinic

You may be asked to fast (not eat anything) from 10pm the night before your clinic appointment. This is so that we can take some specialist blood tests.

Please drink plenty of water though; you need to be hydrated for the appointment. If you usually take any diabetic medicine or short acting insulin in the morning, please do not take this but bring it with you. Also, if you are on insulin treatment please ensure you have your usual hypo rescue treatment to hand (carton of orange juice, dextrose tablets, etc.)

We measure different substances in the blood including glucose, insulin and fat (triglyceride and cholesterol) levels. The levels of these substances change a great deal after meals depending on exactly what one eats, so unless you have eaten a specific meal, interpretation of these tests will vary widely. The results of these blood tests help us to decide on treatment starts and changes.

If you feel that you are unable to fast for your appointment, you can contact a member of the team to discuss what alternative arrangements could be put in place as we can usefully measure some indices without you having to fast.

Who will I see at the clinic?

We have a multidisciplinary team-run clinic, including a doctor, specialist nurse and dietitian. It may be that during your consultations we are all present in the room. This is to help prevent you having to keep repeating yourself to each different staff member.

We hope this gives a more holistic/team approach. However, if you would prefer to be seen by one member of staff at a time then it is absolutely fine to let the doctor or nurse know when they call you in. Alternatively you can phone in advance and let us know.

Should I bring anything with me?

• It is helpful to us if you bring a list of any medication you are on.
• If you check your blood sugar please can you bring your monitoring diary.

What will happen at the clinic?

• When you arrive at the Wolfson Diabetes and Endocrine Clinic, please see the receptionist who will check your details.
• You will then have your height, weight and blood pressure measured, and we will take some of your blood for testing in our Phlebotomy department which is directly opposite the WDEC clinic. If Phlebotomy is closed, sometimes the clinic nurses will take blood samples instead.
• At your appointment time, the doctor will call you in and will ask you about your medical history and any symptoms you may have. If they can recommend a treatment or way of managing the condition, they will explain this too.
• You may be examined, so be prepared to undress to your underwear.
• The doctor may ask you about your family history and may draw a family tree diagram. If the doctor thinks that the cause of your condition may have passed down in your family they may suggest genetic testing. This will be explained in more detail at your appointment if appropriate to you.
• You may see the dietitian and/or specialist nurse after your appointment with the doctor.
• You may be asked to have an MRI scan. You will receive a separate letter about this if you are going to be asked to have one.
• You may be given information sheets about research studies related to severe insulin resistance and/or lipodystrophy. It is up to you whether or not you would like to take part and your care will not be affected if you choose not to. It is important that you have plenty of time to think about this so you would not be asked to decide on the same day.
• The decision to have further tests or treatments is entirely yours to make.

Can I bring someone with me?

• Yes, in general. We are very happy to see you with one accompanying person but this may be subject to change with social distancing guidance.
• It is a good idea to think about this and discuss your wishes with your family before you come, as not everyone may want the same thing.
• If another family member comes with you, but doesn’t have their own appointment, the team will advise them if they need to be given an appointment for another day.

How will I know what will happen next?

• Before you leave, we will explain what will happen next.
• The staff will discuss together and plan the best way to care for each person we have seen.
• The doctor in clinic routinely writes to the doctor that referred you to the clinic and your GP; you will also receive a copy of this letter.

What if I think of more questions after I leave?

It is good to write these down as soon as you think of them. You can contact us on the number below if you think of any further questions.

It’s a long way to travel - is there somewhere I can stay nearby?

Pemberton House

Pemberton House is an affordable on-site accommodation facility for relatives and patients who may have to travel from a distance and would prefer to arrive the night before. There are twin rooms and one single room available.

To book please call 01223 868300 or for more information, follow this link to the Pemberton House (opens in a new tab).

Elsworth House

Elsworth House also offers a variety of different accommodation. Rooms are available for families and are booked by the wards looking after the patient.

More information is available from Sanctuary Housing (Email Sanctuary)

01223 404800

Sanctuary Addenbrookes (opens in a new tab)

Contacts and further information

Telephone us at the Severe Insulin Resistance Service on 01223 348123.

Email the Severe Insulin Resistance Service