Paediatric diabetes (General Paediatrics)Paediatric
Useful Management Information
- All newly diagnosed/ suspected type 1 diabetes must be seen as an emergency as soon as the diagnosis is suspected.
- Do not wait for blood results to become available.
- To avoid delay in diagnosis, physicians need to take due care in their detection of diabetes in a patient and in defining its clinical sub‐type, since delayed diagnosis of type 1 diabetes in a child or adolescent is associated with an increased risk of DKA and subsequent morbidity and mortality.
- In rural and remote areas, it is preferable that local health professionals, who have access to the specialist paediatric diabetes team, provide ongoing support and education.
- If the child/adolescent/family is unable to access these health professionals, support with education should be provided by the experienced health professional at the provincial or tertiary diabetes centre, via videoconference or phone.
- Explain to children and young people with type 1 diabetes and their family members or carers (as appropriate) that an HbA1c target level of 48 mmol/mol (6.5%) or lower is ideal to minimise the risk of long-term complications.
- Refer to local/regional diabetes education/dietetic services. Registration with NDSS (National diabetes services scheme).
- Develop an individualised management plan, which includes planned interaction with local diabetes educators, dietetic inputs, caregivers, local health team and visiting specialists where necessary.
- Provide ongoing clinical advice and support to local health team and family
- Refer/explain to children and young people with type 1 diabetes and their family members or carers (as appropriate) how to find information about government and benefits available.
- Offer children and young people with type 1 and type 2 diabetes and their family members or carers (as appropriate) timely and ongoing access to mental health professionals with an understanding of diabetes because they may experience psychological problems (such as anxiety, depression, behavioural and conduct disorders and family conflict) or psychosocial difficulties that can impact on the management of diabetes and wellbeing.
- Encourage children and young people with type 1 diabetes to wear or carry something that identifies them as having type 1 diabetes (for example, a bracelet).
- If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, you need to contact Child Safety Services
Minimum Referral Criteria
|Category 1 (appointment within 30 calendar days)|
|Category 2 (appointment within 90 calendar days)|
|Category 3 (appointment within 365 calendar days)|
If your patient does not meet the minimum referral criteria
Essential Referral Information
- History of the presentation including reasons why this is thought to be type 2 diabetes rather than type 1 (e.g. strong family history of type 2, obesity, evidence of insulin resistance [e.g. acanthosis nigricans])
- Report presence or absence of concerning features:
- polyuria or polydipsia
- recent weight loss
- recent onset enuresis
- ketosis on urine or blood testing
Investigations for suspected type 2 diabetes
- Plasma glucose (fasting or random) +/- Oral glucose tolerance test
- Ketones (blood or urine) – if elevated, send direct to emergency
NB follow up/review patients will have pathology attended to in the clinic, the patient is not required to get blood tests prior to attending on an ongoing referral
If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the body of the referral.
Additional Referral Information
Highly desirable information – may change triage category
- Mode of presentation, whether insidious or acute
- Other past medical history
- Family history, especially of diabetes, PCOS and other endocrine conditions
- Height/weight/head circumference and growth charts with prior measurements if available
Desirable Information - will assist at consultation
- Birth history
- Immunisation history
- Developmental history
- Medication history
- Significant psychosocial risk factors (especially parents’ mental health, family violence, housing and financial stress, department of child safety involvement)
- Other physical examination findings inclusive of CNS, birthmarks or dysmorphology
- Any other relevant laboratory tests or medical imaging
Send Referrals To
About Smart Referrals
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Send to: Gold Coast Health Service District
Paediatric Medicine (E-Blueslips)
Paediatric Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215
If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.
If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, contact Department of Children, Youth Justice and Multicultural Services . Please consider if mandatory reporting applies.