Diabetes Initial Treatment, Management and Education

Does the newly diagnosed patient need insulin?

     If type 1 diabetes is suspected the patient should be referred to secondary care diabetes services urgently.

  • Most patients are young (<50 years), but insulin may be required at any age
  • BMI often less than 25kg/m2
  • Check urine for ketones. Anything more than minimal ketosis is a strong indication for insulin
  • Often associated with marked hyperglycaemia, rapid weight loss and rapid onset of severe symptoms
  • Some people may have a personal and/or family history of autoimmune disease
  • Severely ill patients may show features of acidosis including deep, sighing respiration and alteration in conscious level and require urgent hospitalisation
  • Protracted vomiting or ketonuria (Type 1)
  • Same day referral to secondary care diabetes services for insulin initiation
  • Newly diagnosed Type 1
  • Do not routinely measure C-peptide and/or diabetes-specific autoantibody titres to confirm type 1 diabetes in adults
  • Clinical support group
    • Endocrine and Diabetes

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