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Diabetes, new presentations and suspected diagnoses

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Diabetes

Abstract

From www.ggc-youngdiabetes.org

Diabetes, new diagnosis - 'walking wounded' presentation

Where diagnosis of diabetes is likely, and the patient is not in DKA, venous bloods should be taken to confirm the diagnosis.  Only then should insulin be commenced as per the Walking Wounded Protocol.  (Updated 2010)

Please note that due to the age of this protocol, which pre-dated the use of TrakCare in NHS GGC, the following order set should now be used to request the required bloods:  Paeds ED New Diab - Set.

The New Diagnosis - DKA Presentation:

Please obtain confirmatory bloods as above and treat as described in the section on Diabetic Ketoacidosis

For NHS Staff

As with everything on this website, this section can be accessed by anyone but it is primarily for hospital staff looking after children and young people with diabetes in NHS Greater Glasgow and Clyde.

The Diabetes "Hot Nurse" - 84646

Referrals for patients to be seen by the diabetes team as an in-patient should be made by phoning the "Hot Phone".  One of the diabetes nurses - the "Hot Nurse" - carries this phone and is available to see in-patients Monday to Friday from 8am, excluding Public Holidays.  However, the Hot Nurse can be called at any time and a message left on their voicemail if outwith normal working hours.

Please phone the Hot Nurse as soon as you are able to do so.  If a patient attends in the evening or overnight, for example, but the Hot Nurse does not hear about this until 8am the next day, it may delay them seeing the patient, carrying out education, and ultimately the patient's discharge from hospital.

84646

New Presentations and Suspected Diagnoses

A Note for GP's:

If a child presents with symptoms suggestive of diabetes, please refer them immediately to the Emergency Department at the Royal Hospital for Children.

Children living on the Western Isles can be referred to their nearest Emergency Department on Lewis, Benbecula or Barra, where they can liaise with the team in Glasgow about whether they can be managed locally or need to be transferred to Glasgow.

Contents:

  • The New Diagnosis - Walking Wounded Presentation
    Where diagnosis of diabetes is likely, and the patient is not in DKA, venous bloods should be taken to confirm the diagnosis (see below).  Only then should insulin be commenced as per the Walking Wounded Protocol.  (Updated 2010)
    Please note that due to the age of this protocol, which pre-dated the use of TrakCare in NHS GGC, the following order set should now be used to request the required bloods:  Paeds ED New Diab - Set
  • The New Diagnosis - DKA Presentation
    Please obtain confirmatory bloods as above and treat as described in the section on Diabetic Ketoacidosis.
  • Presentations where Diabetes in Unconfirmed
    Sometimes children present with few symptoms and/or their glucose on arrival at the Emergency Department does not meet the World Health Organization's diagnostic criteria.  In these cases, please refer to this document.

  • Walking Wounded Insulin Dosing
  • Investigations
Editorial Information

Last reviewed: 08 November 2023

Next review: 30 November 2025

Author(s): Ian Craigie, Ken Robertson

Approved By: GGC Children's Diabetes Service