Paeds Cases · endocrinology-diabetes-and-growth

Type 1 diabetes: diagnosis and initial management — structured clinical encounter

Structured encounter testing the diagnosis and first management of a six-year-old with a two-week history of thirst, polyuria and weight loss who is alert and not acidotic with a glucose of 22 mmol/L: confirming the diagnosis on glucose, excluding ketoacidosis at the bedside, naming the type with autoantibodies and C-peptide, starting subcutaneous basal-bolus insulin, delivering structured family education, and explaining the honeymoon phase and the rule that insulin is never stopped.