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Managing Diabetes 2019

Professionals: be vigilant and do finger prick glucose check when diabetes suspected

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Dr Anna Clarke

Advocacy and Research Manager, Diabetes Ireland

Type 1 diabetes onset is rapid (days-weeks), with aggressive deterioration once symptoms present. Prompt diagnosis prevents life-threatening illness and conveys better lifelong health outcomes; healthcare professionals must finger prick glucose check if in doubt.


What is Diabetes?

Type 1 diabetes is a lifelong condition in which the pancreas produces little or no insulin, a hormone needed to allow glucose to enter cells to produce energy. The more common type 2 diabetes occurs when the body becomes resistant to insulin or doesn’t make enough insulin. While both type 1 and type 2 diabetes result in high blood glucose levels, the development and management are very distinct.

There is currently no cure for type 1 diabetes and insulin by injection is the only form of treatment.

What can happen if diagnosis is delayed

There is currently an alarming rise in the number of young people being admitted to hospitals with a new diagnosis of type 1 diabetes, which was not diagnosed immediately, resulting in a potentially life-threatening condition called diabetic ketoacidosis (DKA). This is 17% of the approximate 250 new cases annually.

Prompt diagnosis of type 1 diabetes means earlier administration of insulin and thereby better lifelong health.

These young people would have presented to a professional with symptoms of high glucose levels such as thirst, weight loss, frequent urination etc. but would have been asked to return in subsequent days for a fasting blood test.

However, a simple finger prick glucose test, done immediately, could lead to prompt diagnosis and avoid the risk of developing DKA.

How does type 1 diabetes develop, what will show?

A combination of genetic (hereditary) and environmental (exposure) factors are thought to trigger the destruction of the pancreatic beta cells (insulin producing cells).

The actual cause remains elusive, as does a cure or method of prevention. The destruction of the beta cells occurs over weeks/months when the young person usually presents with thirst and frequent urination (bedwetting in previously dry child). These symptoms can be mistaken for urinary tract infections.

If DKA is developing, the young person may complain of abdominal pain, dehydration and extreme lethargy. These symptoms are all similar to gastroenteritis but, unfortunately, if missed can lead to loss of consciousness and hyperventilation (i.e. DKA) – requiring urgent, intensive therapy.

What can parents and guardians do?

Because parents know their children well, they can be the first to pick up minor changes such as being extra thirsty or needing the bathroom more frequently. If these signs are concern to the extent of seeking a medical explanation – don’t hesitate to ask your doctor/practice nurse or local pharmacy to do a finger prick blood glucose check (in a younger child, a urine glucose check).

Prompt action could avoid your child spending days in intensive care, and prompt diagnosis of type 1 diabetes means earlier administration of insulin and thereby better lifelong health.

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