Summary
Definition
History and exam
Key diagnostic factors
- hyperglycaemia
- polyuria
- polydipsia
Other diagnostic factors
- young age
- weight loss
- blurred vision
- nausea and vomiting
- abdominal pain
- clinical dehydration
- abdominal pain
- tachypnoea
- lethargy
- coma or altered mental status
Risk factors
- genetic predisposition
- geographical region
- infectious agents
- dietary factors
Diagnostic investigations
1st investigations to order
- random plasma glucose (children)
- fasting plasma glucose (children)
- 2-hour plasma glucose (children)
- HbA1c (children)
- clinical diagnosis (adults)
Investigations to consider
- plasma or urine ketones
- C-peptide
- autoimmune markers
Treatment algorithm
children and non-pregnant adults
pregnant
Contributors
Authors
Eveleigh Nicholson, MBBS, FRCP
Consultant Endocrinologist
Portsmouth Hospitals University NHS Trust
UK
Disclosures
EN has received honoraria for educational activities/advisory boards from NovoNordisk, Eli Lilly and Boehringer Ingelheim.
Sze May Ng, MBBS (Hons), FHEA, FRCPCH, SFFMLM, MSc, LLM, MBA, PhD
Honorary Associate Professor
University of Liverpool
Consultant Paediatrician and Paediatric Endocrinologist
Southport and Ormskirk NHS Trust
UK
Disclosures
SMN declares that she has no competing interests.
Partha Kar, OBE, MBBS MD, FRCP
Consultant Endocrinologist
Portsmouth Hospitals University NHS Trust
National Specialty Advisor, Diabetes, NHS England
UK
Disclosures
PK has sat on advisory boards and attended events reimbursed by Novo Nordisk, Eli Lilly and Sanofi.
Acknowledgements
Dr Eveleigh Nicholson, Dr Sze May Ng, and Professor Partha Kar would like to gratefully acknowledge Dr Rajesh K. Garg and Dr Varsha Vimalananda, the previous contributors to this topic.
Disclosures
RKG is an author of a number of references cited in this topic. VV declares that she has no competing interests.
Peer reviewers
Omar Mustafa, MBChB, FRCP
Consultant Physician in Diabetes
Senior Lecturer in Medical Education
King's College Hospital NHS Foundation Trust
King’s College London
London
UK
Disclosures
OM has received honoraria for educational activities/lectures from NovoNordisk, Eli Lilly, Sanofi, and Boehringer Ingelheim.
Hood Thabit, MB, BCh, MD, PhD
Consultant Diabetologist & Honorary Senior Lecturer
Manchester University Hospitals NHS Foundation Trust
University of Manchester
Manchester
UK
Disclosures
HT has received research support from Dexcom, Inc., and speaker fees from Eli Lilly.
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