Doctors warn of 'lack of awareness' of child diabetes among UK health professionals

[Northerner]

Doctors in Southampton and Oxford have warned that UK health professionals’ failure to recognise the symptoms of type 1 diabetes is putting children’s lives at risk.

Dr Justin Davies, a consultant paediatric endocrinologist at Southampton Children’s Hospital, said a lack of awareness meant patients were being sent to multiple clinicians, having unnecessary investigations, missing out on crucial finger-prick blood tests and, ultimately, receiving misdiagnoses.

When treatment with insulin is delayed, patients with type 1 diabetes are at increased risk of a potentially fatal complication diabetic ketoacidosis (DKA), which occurs when the body breaks down fat as an alternative source of fuel in the absence of insulin.

DKA is present in 25% of the 2,000 children newly diagnosed with type 1 diabetes annually in the UK and is responsible for ten deaths a year.

http://www.uhs.nhs.uk/AboutTheTrust...d-diabetes-among-UK-health-professionals.aspx

 

[HOBIE]

There is a lot of people that think they know about Diabetes but have not got a clue. Inc normal nurses. When I was younger I wanted T1 & T2 to be two different illnesses because of what people would say to me. "Arnt you young to be Diabetic" & look at me as though it was my fault. Its better than it used to be but 😱

 

[trophywench]

They used to say that to me too Hobie, cos they'd only met older people who were T2 - I was 22 ! Then when I said I was T1, apparently you can only get that as a child so I must be wrong!

Now I'm a pensioner assumptions are still made - even by medics sometimes! - that I'm T2 !!

 

[Sally71]

When my daughter was dx I could see the GP thought I was just being a neurotic mum and wanted to send me home again. He did a urine test which was apparently normal, but then did say that he wouldn't be doing his job properly if he didn't investigate symptoms like that. So sent daughter for a full battery of blood tests, but said it had to be fasting so we had to wait a few days. At the time I didn't know enough to argue with him and as her decline had been fairly slow until that point I thought what difference does a few more days make.

Unfortunately it made quite a lot of difference, by the time the day of the test came DKA was beginning to kick in and she was going downhill fast. GP called us back the next day, hubby had to carry her in as by that point she hardly had the strength to stand up, never mind walk. I think if we'd waited one more day she would have been in a coma . GP looked like he'd had a bigger shock than I had, hopefully he realised that he had narrowly avoided a potentially career-ending mistake! Fasting BG was 18, finger prick test was off the scale, urine now full of sugar and ketones (and this was only 6 days after the original "normal" urine test). She was admitted to hospital with mild-moderate DKA and a BG of 46 and had to be put on fluids for an hour before they could start insulin.

DSNs said that they wanted to do more training with GPs as most of them know shockingly little about diabetes, and most of what they do know is based on T2 because that's what they usually see. Fasting blood test would have been correct for diagnosing T2 but not T1.

Doesn't sound like things have changed! GPs can't possibly know everything about everything, but surely they could at least know that when presented with a child with classic diabetes symptoms, do a fingerprick test and if it's anywhere above normal then refer them straight to hospital for more thorough testing!

 

[Northerner]

...Doesn't sound like things have changed! GPs can't possibly know everything about everything, but surely they could at least know that when presented with a child with classic diabetes symptoms, do a fingerprick test and if it's anywhere above normal then refer them straight to hospital for more thorough testing!

It astonishes me that so many don't just do that simple fingerprick test, it could tell them so much in seconds! 😱

I never saw a GP, but I would have been interested to know what conclusions they would have come to had I been able to. I suspect that they would have put it down to the virus I had and sent me home, with no tests for diabetes. I went from being ready to run a marathon to almost comatose in 4 days 😱

 

[KookyCat]

They do need to improve the situation, I was told to stop being neurotic when I asked about type 2, too thin, too young, too active. Nobody even considered type 1, even after a test showed negative for pernicious anaemia but was flagged as "odd" because it showed a protein suggesting an immune reaction, just not the one they were looking for. Still nobody twigged until I was in a coma with a blood sugar of 61 and a blood Ph of a battery.

I'd have thought that they'd be more aware with kids though given that we keep being told its most likely to appear in childhood, and even if they know mostly about T2 many of the symptoms are similar. Very frustrating 😡

That said a friend of mine with T2 had to go back to her GP four times before they tested her blood sugar. She's slender and active (a triathlete) and that seemed to distract. I wonder how much some GPs actually know about diabetes in general, or if they just work on cliches and assumptions.

 

[Northerner]

...That said a friend of mine with T2 had to go back to her GP four times before they tested her blood sugar. She's slender and active (a triathlete) and that seemed to distract. I wonder how much some GPs actually know about diabetes in general, or if they just work on cliches and assumptions.

I'm always horrified when I read of a GP or nurse who thinks a T2 needs to be fat and over 40, and a T1 can only be a child - and are completely ignorant that you can be slim and active and T2, and over 18 and a T1. From all accounts, half of T1s are diagnosed as adults in the 35-49 age group (the study only included up to 49, but there are cases of T1 in over 80s 😱 )

 

[Sally71]

Sorry Kooky - "blood pH of a battery" - made me laugh out loud!

Not funny really though is it. I know GPs are GENERAL practitioners but the least they need to know is how to recognise when symptoms might be life threatening and need to be acted on quickly! Such as DKA, preferably before you've developed it...

 

[trophywench]

I have to say nearly all our grandchildren have been 'lucky' enough to use grandmas magic machine when we've been concerned - you know, raging thirst that seems to be lasting a bit too long; loss of weight; lethargy - they've all been 100% fine but both daughters are well versed in the symptoms anyway - youngest one's best mate (they're now in their 40s!) was T1 (and Pete used to either do her tests and jabs when she was little or oversee them when she came to stay or later went on holiday with them) so none of it was exactly new when I showed up LOL

Eldest is a chef and one of the others is T1, other staff used to offer him a glass of water and suchlike when he was hypo - and she's been able to educate them, for him really - he doesn't communicate that well once he's gone, LOL

But anyway - it all helps get the word out doesn't it?

Anyway I keep a spare meter for suchlike now I'm pumping and their mothers would take it with the child straight to A&E if the result merited it and cut out the middle man.