GPs are part of the multidisciplinary team caring for children and adolescents with type 1 diabetes and have an important role in managing intercurrent illnesses and general health needs.
- Early diagnosis of type 1 diabetes and prompt referral to a physician skilled in managing children with diabetes is important to avoid diabetic ketoacidosis.
- There is no need to wait for a fasting blood glucose level (BGL) in a child who has symptoms suggestive of diabetes. The fasting BGL may remain normal early on.
- Common insulin regimens for children with type 1 diabetes are multiple daily injections, twice-daily injections and insulin pumps. Knowledge of speed of onset and duration of action of the various insulins is useful for problem solving.
- Management of diabetes during illness requires frequent monitoring of blood glucose and ketone levels as adjustments to insulin doses are usually needed.
- The use of insulin pumps is increasing. The pump only delivers rapid-acting insulin so if delivery of insulin is interrupted, BGLs rise quickly. Immediate attention is required, and even small levels of ketones should not be ignored.