Diagnosis and management of diabetes in children and young people: summary of updated NICE guidance

What you need to know Immediately refer any child or young person with suspected type 1 diabetes characterised by random plasma glucose >11 mmol/L, polyuria, polydipsia, weight loss, excessive tiredness, or DKA to a multidisciplinary paediatric diabetes team Agree an individualised lowest achieva...

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Bibliographic Details
Published in:BMJ (Online) 2016-01, Vol.352 (8042), p.i139-i139
Main Authors: Beckles, Zosia L, Edge, Julie A, Mugglestone, Moira A, Murphy, M Stephen, Wales, Jerry K H
Format: Article
Language:English
Subjects:
Adolescent
Adults
Blood Glucose
Blood Glucose Self-Monitoring - methods
Carbohydrates
Child
Child, Preschool
Children & youth
Diabetes
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 1 - diagnosis
Diabetes Mellitus, Type 1 - drug therapy
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - diagnosis
Diabetes Mellitus, Type 2 - drug therapy
Disease Management
Drug Administration Schedule
Education
Families & family life
Fatigue
Foot diseases
Glucose
Humans
Hyperglycemia
Hypoglycemia
Hypoglycemic Agents - therapeutic use
Insulin
Insulin - blood
Insulin - therapeutic use
Insulin resistance
Medical History Taking
Mental health
Patient Education as Topic
Polydipsia
Polyuria
Practice Guidelines as Topic
Quality
Referral and Consultation - organization & administration
Weight Loss
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Summary:What you need to know Immediately refer any child or young person with suspected type 1 diabetes characterised by random plasma glucose >11 mmol/L, polyuria, polydipsia, weight loss, excessive tiredness, or DKA to a multidisciplinary paediatric diabetes team Agree an individualised lowest achievable HbA1c target, taking into account daily activities, life goals, complications, comorbidities, and, in type 1 diabetes, the risk of hypoglycaemia For type 1 diabetes, offer multiple daily injection basal-bolus insulin regimens with level 3 carbohydrate counting education from diagnosis, provide blood ketone testing strips and a meter, and advise testing for ketonaemia if the child is ill or has hyperglycaemia For type 2 diabetes, offer standard release metformin from diagnosis Type 1 diabetes affects more than 25000 children and young people in the United Kingdom and type 2 affects about 500, with both types becoming more common. 1 Life threatening complications, including diabetic ketoacidosis (DKA), can occur with both type 1 and type 2 diabetes. Psychological and social issues Psychological problems (such as anxiety, depression, behavioural and conduct disorders, and family conflict) or psychosocial difficulties may arise in both types of diabetes, and they may affect wellbeing and the management of diabetes. [...]offer timely and ongoing access to mental health professionals with an understanding of diabetes.
ISSN:1756-1833
0959-8138
1756-1833
DOI:10.1136/bmj.i139