Diabetes

WHO criteria for Diagnosing Diabetes

The presence of diabetic symptoms (polyuria, polydipsia, and

unexplained weight loss) plus

fasting plasma glucose (FPG) 7.0 mmol/l or

plasma glucose 11.1 mmol/l at two hours after a 75g oral glucose
load (OGTT)
Screening Recommendations

Psychosocial
Associated Conditions
Gestational Diabetes
Kidney Disease
Visual Impairment
Food disease
Psychosocial

Regular assessment of a broad range of psychological & behavioral

problems in children & adults with T1DM is recommended

In children = eating disorders, behavioral, emotionald and family

functioning problems

In adults = anxiety, depression and eating disorders

Associated Conditions

Patients with CF , screen annually from 10 yrs old

Young people with diabetes, screen for thyroid and coeliac disease
at onset of diabetes and intervals throughout their lives
Cystic Fibrosis

Autosomal recessive
CFTR gene
Mostly lung, but also intestines, pancreas, liver, kidney
CF
Gestational Diabetes

All women with risk factors should have HbA1c or fasting glucose
measured

All women with risk factors should have a 75 g OGTT at 24 28

weeks

A fasting plasma glucose at 24 28 weeks is recommended in low-

risk women
Kidney Disease

ACR should be used to screen for diabetic kidney disease

Young people with diabetes should have ACR tested annually from
age of 12 years
ACR

Albumin Creatinine Ratio

Compare albumin against creatinine

Visual Impairment

Systematic screening for diabetes retinal disease for all patients

People with T1DM screened from 12 yrs old

People with T2DM screened from diagnosis

If diabetes with no diabetic retinopathy , screen every 2 years

FOOT DISEASE

All diabetes patients should be screened

People with diabetes develop foot ulcers because of neuropathy,

ischaemia or both

Charcot foot
Charcot Foot
MANAGEMENT OF TYPE 1 DIABETES

Diagnosis & Screening

Pre-type T1DM screening NOT recommended

CF patients screened annually

Thyroid & coeliac

MANAGEMENT OF TYPE 1 DIABETES

Continuing Management

Insulin therapy
Continuous Subcutaneous Insulin Infusion (CSII)
Dietary management
Management of diabetes at school
Insulin Therapy

Tx regimen for adults with T1DM should include either human or

rapid acting insulin analogues

Basal insulin analouges recommended in adults with T1DM who

experience severe or nocturnal hypoglycaemia
CSII

CSII therapy is associated with modest improvements in

glycaemic control & should be considered for patients unable to
achieve their glycaemic targets

CSII therapy should be considered in patients that experience

recurring episodes of severe hypoglycaemia
Dietary Management

Dietary advice recommended to improve glycaemic control

MANAGEMENT OF TYPE 1 DIABETES

Continuing Management

Insulin therapy
Continuous Subcutaneous Insulin Infusion (CSII)
Dietary management
Management of diabetes at school
Pharmacological Management of Glycaemic
Control in People With T2DM