presentation title diagnosing diabetes in childhood
TRANSCRIPT
Presentation title
Diagnosing diabetes in Childhood
1 Suspecting diabetes
Confirming the diagnosis
Programme
2
Presentation title
Suspecting diabetes
Diabetes in childhood
• How does diabetes in children develop?
• Why should children with diabetes be treated differently from most adults with diabetes?
• Why can children with diabetes become so ill, and sometimes die?
Slide no 4
Diabetes
• Group of disorders characterised by chronically high blood glucose levels.
• Glucose in blood comes from• Food (food converted to glucose in the liver)
• Stores (energy stored in liver, muscle and fat)
• Glucose provides energy to cells and organs• Requires insulin to move from blood to cells
Slide no 5
Insulin
• Hormone secreted by the pancreas• Produced by β-cells of the pancreas• Diabetes occurs if:
• Pancreas does not produce enough insulin (type 1 diabetes)
• Effect of insulin decreased (type 2 diabetes)
Slide no 6
Glucose
Glucose
• Food converted to glucose
• Glucose is the main source of energy for cells
• Glucose unable to enter cells without insulin
7
Blood vessel Cell
Insulin
• Pancreas secretes insulin
• Insulin moves glucose into cells and provides energy for the cell
8
Insulin
Pancreas
Type 1 diabetes
• Too little insulin from pancreas
• Glucose accumulates in blood
• Not enough energy in cells
• Lethargic
9
Type 1 Diabetes (cont.)
• Blood circulates through kidneys
• Glucose excreted in urine (attracts ants)
• Increased urine• Enuresis• Dehydration and
weight Loss• Increased drinking
10
Cell
Type 1 Diabetes (cont.)
• Body breaks down stores in liver, muscle and fat to produce more energy
• Weight loss
• Ketones
11
Liver
Muscle
Fat
Weight lossKetones
Ketones
• Common feature of type 1 diabetes• Rare in type 2 diabetes• Occurs because of a breakdown of fat• Is life-threatening• Signs and symptoms:
• Sweet smell on breath• Vomiting• Stomach pain• Rapid/acidotic breathing• Altered level of consciousness
Slide no 12
Symptoms and signs of type 1 diabetes
• Symptoms:• Lethargy• Increased urination*• Increased thirst• Bed wetting*• Vomiting
• Signs:• Weight loss• Dehydrated• Altered level of
consciousness• Acidotic/rapid breathing• Fruity odour
Slide no 13
*) Great question to distinguish
from most other dehydration
illnesses in your emergency room
World Diabetes Day poster
Slide no 14
Type 2 diabetes
• Usually seen in older people
• Due to resistance to effects of insulin
• Often associated with obesity
• Often asymptomatic
• Treated with life style change and oral medications
• Increasingly seen in youth as they get more obese at younger and younger ages around the world
Slide no 15
Other types of diabetes
• Malnutrition associated diabetes
• Neonatal diabetes
• Maturity onset diabetes of the young
• Gestational diabetes
Slide no 16
Questions
Presentation title
Confirming the diagnosis
Criteria for diagnosis
• Symptoms of diabetes plus casual/random plasma glucose concentration above or equal 11.1 mmol/l (200 mg/dl)
OR
• Fasting plasma glucose above or equal 7.0 mmol/l (126 mg/dl)
• Laboratory blood glucose
• Glucometer
Slide no 19
Making a diagnosis
• If blood glucose testing not available
• Urine dipstix:• Glucose
• Ketones
• If ketones are present in urine or blood, treatment is urgent and the child should be treated the same day to avoid the development of ketoacidosis (DKA)
Slide no 20
Glucose meters
• Portable device that measures blood glucose
• Drop of blood placed on plastic strip
• Result in 5-10 seconds
• Accurate
• Meters require coding and strips may expire
• Be aware of difference between glucose meters and laboratory glucose values
Slide no 21
Precautions
• Strips – brand, code and expiry date
• Confirm units of measure (mmol/l, mg/dl)
• Wash hands (yours and the patients)
• Technique
• Dispose of strips after use
• Do not share or reuse lancets
• Dispose lancets safely
Slide no 22
Intermission
• Using blood glucose meters
• Using urine dipstix
Slide no 23
Questions
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