Diabetes in Paeds

Question 1

what is the fasting glucose of the child upon diagnosis?

Answer 1

<7mmol/L

Question 2

what is the plasma glucose 2 hours after the oral glucose tolerance test?

Answer 2

> 11.1mmol/L

Question 3

what is used in the oral glucose tolerance test (OGTT)?

Answer 3

75g of glucose dissolved in water

Question 4

what is not used in paediatrics but is used in adults to diagnose diabetes?

Answer 4

HbA1c levels

Question 5

what type of diabetes is deafness a sign of?

Answer 5

mitochondrial diabetes

Question 6

what is the national mean HbA1c for children and young people with Type 1 diabetes?

Answer 6

67.5 mmol/mol

Question 7

what are the complications of a DKA in children/adolescents?

Answer 7

1. Cerebral oedema
2. Hypokalaemia
3. Venous thromboembolism

Question 8

how do we treat a DKA?

Answer 8

1. give subcutaneous insulin (basal not bolus)
2. oral hydration
3. 40mmol/L of potassium

Question 9

what are the treatment options for type 1 diabetes in children?

Answer 9

1. Basal-Bolus Regimens.
2. CSII ( continuous subcutaneous insulin infusion).
3. Mixed insulins.

Question 10

when would you give a CSII (continuous subcutaneous insulin infusion)?

Answer 10

1. Type 1 Diabetes
AND:
2. > 12yrs old with disabling hypos or HbA1c is >69mmol/mol on MDI
3. < 12 yrs old if MDI not
practical/appropriate

Question 11

how does the C-peptide help to diagnose diabetes in children and what type of diabetes?

Answer 11

When its levels are elevated this indicates type 2 Diabetes

Question 12

how is type 2 diabetes treated in paeds?

Answer 12

Only insulin and metformin approved for use however, Sulphonyureas are approved in some countries

Question 13

How often should paeds attend clinic to check up their diabetes control?

Answer 13

should attend clinic if possible at least 4 x/year