Position statements

There is a need for children with the early signs and symptoms of Type 1 diabetes to be diagnosed promptly, before they become acutely unwell with diabetic ketoacidosis, because:

• The incidence of Type 1 diabetes in children and young people is increasing by approximately 4% per year in the UK 1
• However the percentage of children not diagnosed with diabetes until they are in diabetic ketoacidosis (DKA) has remained unchanged over the last 20 years 2,3
• Approximately 25% of all newly diagnosed children are not diagnosed until they are in DKA 2 and this rises to 35% in children under five 2,3
• DKA is the leading cause of death in children with diabetes. Ten children die every year from DKA 4

Diabetes UK recommends that:

• Parents of children with any of the symptoms of Type 1 diabetes should see a doctor straight away for immediate capillary blood glucose testing. Urine glucose testing should only be performed if a child can void immediately, and will always require confirmation by a capillary blood glucose test.
• All GP’s, primary healthcare professionals, health visitors, school nurses and other non-specialist healthcare professionals should be educated in the symptoms of and referral pathway for children with suspected Type 1 diabetes.
• Any child suspected to have Type 1 diabetes should have a same day referral to a specialist paediatric diabetes team for confirmation of diagnosis and management.
• The number of children diagnosed in DKA should be monitored and audited nationally.
• Specialist paediatric diabetes teams should be aware of the rarer forms of diabetes (such as monogenic diabetes),  and to refer children with signs of these rarer forms for specialist testing and management.