Type 2 diabetes, pre-diabetes and type 1 shared care at 24 Wellington Street, run as a proper annual cycle rather than a prescription and a wave. Pathology is on site, the care plan and its reviews are bulk billed, and several of the doctors here managed diabetic patients in hospital before they worked in general practice.
What we look after
- Type 2 diabetes – diagnosis, treatment, the annual cycle of care and long-term review
- Pre-diabetes – the stage where the diagnosis is still avoidable, and the one most worth acting on
- Type 1 diabetes – shared care with your endocrinologist, including scripts, monitoring and the yearly checks
- Gestational diabetes – during pregnancy alongside antenatal shared care, and the follow-up test afterwards that is so often missed
- Diabetes with other conditions running alongside it – kidney disease, heart disease, high blood pressure, sleep apnoea, fatty liver
- Diabetes-related foot problems, and referral when a wound needs it
The annual cycle of care – what actually gets checked
The annual cycle of care is the national checklist for diabetes. Done properly it is the single thing that most reduces the risk of complications. Done casually, it is a blood test once a year. Here is what we run, and when:
- HbA1c – every three to six months depending on how stable things are. General target is 7% (53 mmol/mol) or lower, though your own target is set with your doctor and is not the same for everyone.
- Blood pressure – at every visit. General target in diabetes is under 130/80.
- Cholesterol and triglycerides – at least yearly.
- Kidney function – eGFR and urine albumin-to-creatinine ratio at least yearly. This is the check most often skipped, and the one that picks up diabetic kidney disease early enough to change the outcome.
- Eyes – a retinal check every one to two years, arranged with an optometrist or ophthalmologist.
- Feet – a full foot check at least yearly: pulses, sensation, skin and nails. More often if sensation is reduced or circulation is poor.
- Weight and waist – tracked over time, with an InBody body composition scan available if you want to see muscle and fat separately rather than one number.
- Smoking, alcohol, activity and diet – reviewed, with real help offered rather than a lecture.
- Mood – depression is roughly twice as common in people with diabetes, and it makes every other part of management harder. It gets asked about.
- Vaccinations – influenza and pneumococcal cover as recommended; see immunisations.
Your diabetes care plan
The way Medicare funds this changed on 1 July 2025. The old GP Management Plan and Team Care Arrangement were replaced by a single GP Chronic Condition Management Plan. If you already had a plan under the old system it still counts; it simply moves across at your next review.
What that means in practice:
- You are eligible if you have at least one condition that has lasted, or is likely to last, six months or more. There is no official list of qualifying conditions – it is your doctor’s clinical judgement.
- One plan now covers both the management plan and the referrals to other health professionals.
- The plan needs to be written or reviewed within the last 18 months for you to keep access to the rebated allied health visits.
- With a current plan you can claim up to five individual allied health visits per calendar year (ten for Aboriginal and Torres Strait Islander patients) – for example a dietitian, podiatrist, diabetes educator, physiotherapist or exercise physiologist.
- You can also have up to five services from a practice nurse on your doctor’s behalf.
- If you are registered with us through MyMedicare, your plan is written here, at the practice you are registered with. If you are not registered, your usual GP can still write it.
Care plans and their reviews are bulk billed at Health Nexus. There is no out-of-pocket cost for writing the plan or for reviewing it.
For type 2 diabetes there is one extra entitlement worth knowing about: as well as the individual visits, you can be assessed for group services and, if they suit you, attend up to eight group sessions with a dietitian, diabetes educator or exercise physiologist in a calendar year.
Treatment
Treatment is decided with you at the consultation, and it is reviewed as things change. What is right depends on your HbA1c, your kidneys, your heart, your weight, what you have already tried and what you are willing to live with. Your doctor will go through all of the suitable options with you, prescribe and monitor whatever is decided, and adjust it at review rather than leaving you on the same thing for years by default.
Nothing about diabetes treatment is one-size-fits-all, and nothing here is prescribed without a conversation about what it does, what it costs and what to watch for.
What to expect
Book a long appointment for a new diagnosis or an annual review and say what it is about. Bring your glucose meter or sensor readings if you use one, a list of everything you take including supplements, and any recent results from elsewhere. Have your bloods done a few days before the appointment if you can – pathology is on site – so the results are in front of your doctor on the day rather than a week later.
After the plan is written, expect to be seen every three to six months. The nursing team will contact you when the next set of checks is due.
Much of the monitoring and recall work is done by the practice nursing team alongside your doctor. The nurses run the checks that are due, keep the recalls on schedule and prepare the review so that your appointment with the doctor is spent on decisions rather than data entry. It is also why the reviews actually happen – the most common reason chronic disease care fails is that the review is never booked.
The doctors
All of the doctors who work from Health Nexus manage long-term conditions. Several have substantial hospital experience behind them:
- Dr John Esho – medical registrar in multiple specialties across northern and north-west Tasmanian hospitals, including cardiology and nephrology; internal and general medicine
- Dr Arsalan (Sam) Mahmud – medical registrar in multiple specialties across northern and north-west Tasmanian hospitals; general and emergency medicine, and continues to work in acute care
- Dr Asim Razak – chronic disease, cardiovascular and respiratory conditions
- Dr Sai Tip – chronic disease, respiratory medicine
- Dr Miyulasi Attanayake – chronic disease, diabetes, hypertension, asthma and COPD
- Dr Nadia Khan – chronic disease, diabetes and hypertension
- Dr Nalika Hendawitharana – chronic disease, preventive health
Fees and Medicare
Health Nexus Launceston is a mixed-billing practice. Children aged 12 and under are bulk billed whenever the practice is open, including evenings and weekends. Pension card holders over 65 and DVA Gold Card holders are bulk billed on weekdays between 8am and 5pm. Everyone else pays the consultation fee with the Medicare rebate claimed on the spot. The current fees are on the fees and bulk billing page.
The practice is open 8am–8pm Monday to Friday, 8am–5pm Saturday and 9am–5pm Sunday, every day of the year, and on every public holiday at the standard hours for that day.
Common questions
How often should my HbA1c be checked?
Every three to six months for most people, and more often when treatment has just changed or control is unstable. Once things are steady and on target, six-monthly is usually enough.
Is the diabetes care plan bulk billed?
Yes. Care plans and their reviews are bulk billed at Health Nexus – there is no out-of-pocket cost for writing or reviewing the plan. Ordinary consultations are billed as usual; see the fees page.
Do I need a referral to see a dietitian or diabetes educator?
You need a current GP Chronic Condition Management Plan and a referral from your doctor. With those you can claim a Medicare rebate for up to five individual allied health visits per calendar year, and for type 2 diabetes up to eight group sessions on top.
Can I have my eyes and feet checked here?
Feet, yes – a full foot check is part of the cycle of care and is done here. Eyes need a retinal examination, so that is arranged with an optometrist or ophthalmologist and the result comes back to your doctor.
I have pre-diabetes. Is that worth an appointment?
It is the appointment most worth making. Pre-diabetes is the stage where progression to type 2 diabetes can often be prevented, and the things that work are specific and measurable rather than vague advice to eat better.
Do I need a referral to be seen for diabetes?
No. Book a long GP appointment directly, online or by phone.
