Diabetes Initial Management (Type 1 - Type 2 education - lifestyle )
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
Education checklist for insulin treated diabetes
Initial lifestyle advice for diabetes - STOP GAP PIL