title: Children and young people with diabetes: recognition and management.
abstract: Diabetes mellitus (type 1) is an autoimmune condition leading to absolute insulin deficiency resulting in hyperglycaemia and its associated manifestations. It is the most common type of diabetes seen in children, characterised by the 4Ts (toilet, thinner, thirsty, tired). The signs and symptoms can sometimes be non-specific and a delay or missed diagnosis may be catastrophic to the health of the child. Children with an established diagnosis of diabetes often present to the health service with issues such as hypoglycaemia, hyperglycaemia, or diabetic ketoacidosis. The condition requires life-long monitoring and strict control of blood glucose levels with insulin replacement therapy, with the aim of achieving an HbA1c level of 48 mmol/mol. There are often physical and psychosocial issues that arise from the diagnosis leading to poor control. Nurses working in different clinical settings play a vital role in raising suspicions of diabetes leading to timely diagnosis and rapid initiation of treatment. They are best placed to provide essential support in helping children and their families to come to terms with the diagnosis, as well as manage this chronic condition by addressing the common issues that arise in the ongoing management, with a particular emphasis on managing the various day-to-day challenges. Two case studies are included to highlight some of the challenges that nurses may encounter while managing children with diabetes.
authors.affiliation: 3rd Year Medical Student, University of Bristol.
authors.forename: Hamish
authors.initials: H
authors.lastname: Hamilton
authors.affiliation: 3rd Year Medical Student, University of Bristol.
authors.forename: Grace
authors.initials: G
authors.lastname: Knudsen
authors.affiliation: Consultant Paediatrician, Yeovil District Hospital.
authors.forename: Camelia Laura
authors.initials: CL
authors.lastname: Vaina
authors.affiliation: Paediatric Diabetes Specialist Nurse, Yeovil District Hospital.
authors.forename: Michelle
authors.initials: M
authors.lastname: Smith
authors.affiliation: Consultant Paediatrician, Torbay Hospital, Torquay.
authors.forename: Siba Prosad
authors.initials: SP
authors.lastname: Paul
mesh_terms: D000293:Adolescent; D057179:Advanced Practice Nursing; D015190:Blood Glucose Self-Monitoring; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000451:nursing* / Q000628:therapy; D016883:Diabetic Ketoacidosis / Q000175:diagnosis / Q000451:nursing* / Q000628:therapy; D019468:Disease Management; D004636:Emergency Service, Hospital; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000451:nursing* / Q000517:prevention & control / Q000628:therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D000072184:Nurse Specialists; D024802:Nurse's Role; D010353:Patient Education as Topic; D010371:Pediatric Nursing; D012573:School Nursing
chemical_list: D007004:Hypoglycemic Agents
keywords: Blood glucose control; Diabetes; Long-term conditions; Paediatric diabetes specialist nurse; Resuscitation