Assessment of diabetic control: - Any episodes of hypoglycaemia, diabetic ketoacidosis, hospital admission? - Is there still awareness of hypoglycaemia? - Absence from school? School supportive of diabetes care? - Interference with normal life? - HbA1c results — 58 mmol/mol (7.5%) or less? - Diary of blood glucose results — if monitoring, is he reacting to results? - Insulin regimen — appropriate? Correction bolus doses given? - Lipohypertrophy or lipoatrophy (Fig. 25.6a and b) at injection sites? - Diet — healthy diet, manipulating food intake and insulin to maintain good control? General overview (periodic): - Normal growth and pubertal development, avoiding obesity — measure each visit - Blood pressure check for hypertension yearly (age-specific centiles) - Renal disease — screening for microalbuminuria yearly from 12 years - Eyes — photography for retinopathy or cataracts, yearly from 12 years - Feet — maintaining good care — yearly - Screening for coeliac and thyroid disease at diagnosis, thyroid screening yearly, coeliac again after 3 years or if weight gain poor. - Annual reminder to have flu vaccination #diabetes #primarycare #DM1 #Peds #Pediatrics #Assessment
