Paediatric Diabetes Workbook

Case 1

Referral

Archie's dipstick reveals the presence of Ketones and Glucose and he is referred to the hospital in keeping with NICE guidance: Children and young people with suspected type 1 diabetes should be offered immediate (same day) referral to a multidisciplinary paediatric diabetes care team that has the competencies needed to confirm diagnosis and to provide immediate care. (NICE, 2004)

Dear Sir,


Archie, Aged 7


c/o Feeling a bit sick in the mornings and bed wetting for 3 weeks.

This AM his urine shows Glucose +++, Ketones +++

o/e Flushed but generally well. No signs of dehydration. CVS Chest Abdo CNS NAD


? Type 1 DM & DKA


Thanks for your management of this patient


Yours faithfully


GP

Multiple Choice Question

In view of the doctor's letter the triage nurse performs a capillary blood glucose test which reveals a blood glucose of 31.6mmol/L.


Following a review of the history and an assessment of Archie's hydration status what is the next most useful investigation in his management?

References
  1. Type 1 diabetes: Diagnosis and management of type 1 diabetes in children, young people and adults