Presentation title
Diagnosing
diabetes in
Childhood
Programme
1
Suspecting diabetes
2
Confirming the diagnosis
Presentation title
Suspecting diabetes
Slide no 4
Diabetes in childhood
• How does diabetes in children develop?
• Why should children with diabetes be treated differently
from most adults with diabetes?
• Why can children with diabetes become so ill, and
sometimes die?
Slide no 5
Diabetes
• Group of disorders characterised by chronically high
blood glucose levels.
• Glucose in blood comes from
• Food (food converted to glucose in the liver)
• Stores (energy stored in liver, muscle and fat)
• Glucose provides energy to cells and organs
• Requires insulin to move from blood to cells
Slide no 6
Insulin
• Hormone secreted by the pancreas
• Produced by β-cells of the pancreas
• Diabetes occurs if:
• Pancreas does not produce enough insulin (type 1
diabetes)
• Effect of insulin decreased (type 2 diabetes)
7
Glucose
• Food converted to
glucose
• Glucose is the main
source of energy for
cells
Glucose
• Glucose unable to
enter cells without
insulin
Blood vessel
Cell
8
Insulin
Insulin
• Pancreas secretes
insulin
Pancreas
• Insulin moves glucose
into cells and provides
energy for the cell
9
Type 1 diabetes
• Too little insulin from
pancreas
• Glucose accumulates in
blood
• Not enough energy in
cells
• Lethargic
10
Type 1 Diabetes (cont.)
• Blood circulates through
kidneys
• Glucose excreted in
urine (attracts ants)
• Increased urine
• Enuresis
• Dehydration and
weight Loss
• Increased drinking
11
Type 1 Diabetes (cont.)
Liver
• Body breaks down
stores in liver,
muscle and fat to
produce more
energy
Muscle
Fat
• Weight loss
• Ketones
Weight loss
Ketones
Cell
Slide no 12
Ketones
•
•
•
•
•
Common feature of type 1 diabetes
Rare in type 2 diabetes
Occurs because of a breakdown of fat
Is life-threatening
Signs and symptoms:
•
•
•
•
•
Sweet smell on breath
Vomiting
Stomach pain
Rapid/acidotic breathing
Altered level of consciousness
Slide no 13
Symptoms and signs of
type 1 diabetes
• Symptoms:
•
•
•
•
•
Lethargy
Increased urination*
Increased thirst
Bed wetting*
Vomiting
*) Great question to distinguish
from most other dehydration
illnesses in your emergency room
• Signs:
• Weight loss
• Dehydrated
• Altered level of
consciousness
• Acidotic/rapid breathing
• Fruity odour
Slide no 14
World Diabetes Day poster
Slide no 15
Type 2 diabetes
• Usually seen in older people
• Due to resistance to effects of insulin
• Often associated with obesity
• Often asymptomatic
• Treated with life style change and oral medications
• Increasingly seen in youth as they get more
obese at younger and younger ages around the
world
Slide no 16
Other types of diabetes
• Malnutrition associated diabetes
• Neonatal diabetes
• Maturity onset diabetes of the young
• Gestational diabetes
Questions
Presentation title
Confirming the diagnosis
Slide no 19
Criteria for diagnosis
• Symptoms of diabetes plus casual/random plasma
glucose concentration above or equal 11.1 mmol/l (200
mg/dl)
OR
• Fasting plasma glucose above or equal 7.0 mmol/l (126
mg/dl)
• Laboratory blood glucose
• Glucometer
Slide no 20
Making a diagnosis
• If blood glucose testing not available
• Urine dipstix:
• Glucose
• Ketones
• If ketones are present in urine or blood, treatment is
urgent and the child should be treated the same day
to avoid the development of ketoacidosis (DKA)
Slide no 21
Glucose meters
• Portable device that measures blood glucose
• Drop of blood placed on plastic strip
• Result in 5-10 seconds
• Accurate
• Meters require coding and strips may expire
• Be aware of difference between glucose meters and
laboratory glucose values
Slide no 22
Precautions
• Strips – brand, code and expiry date
• Confirm units of measure (mmol/l, mg/dl)
• Wash hands (yours and the patients)
• Technique
• Dispose of strips after use
• Do not share or reuse lancets
• Dispose lancets safely
Slide no 23
Intermission
• Using blood glucose meters
• Using urine dipstix
Questions
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