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Feature Article

Tips for troubleshooting in children with type 1 diabetes

Jessica Phillips, Elaine Tham

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Abstract

GPs are part of the multidisciplinary team caring for children and adolescents with type 1 diabetes and have an important role in managing intercurrent illnesses and general health needs.

Key Points

  • Early diagnosis of type 1 diabetes and prompt referral to a physician skilled in managing children with diabetes is important to avoid diabetic ketoacidosis.
  • There is no need to wait for a fasting blood glucose level (BGL) in a child who has symptoms suggestive of diabetes. The fasting BGL may remain normal early on.
  • Common insulin regimens for children with type 1 diabetes are multiple daily injections, twice-daily injections and insulin pumps. Knowledge of speed of onset and duration of action of the various insulins is useful for problem solving.
  • Management of diabetes during illness requires frequent monitoring of blood glucose and ketone levels as adjustments to insulin doses are usually needed.
  • The use of insulin pumps is increasing. The pump only delivers rapid-acting insulin so if delivery of insulin is interrupted, BGLs rise quickly. Immediate attention is required, and even small levels of ketones should not be ignored.

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