Managing diabetes mellitus in children and young people

The management of children and young people with diabetes mellitus is primarily performed in secondary care by multidisciplinary paediatric diabetes teams. However, primary care practitioners need to be alert to symptoms that indicate new-onset diabetes and to arrange referral with appropriate speed for further care. They also need to have a working knowledge of the treatments, monitoring requirements, and complications of diabetes and, in particular, how to manage hypo- and hyperglycaemia. When defining children and young people, children are considered to be younger than 11 years and young people to be aged 11-17 years.

Developing diabetes
Approximately one in 450 children and young people develop diabetes, and, of these, 97 per cent have type 1 diabetes.¹ Type 1 diabetes is an autoimmune disease with autoantibodies causing destruction of the insulin-producing pancreatic islet beta-cells. The peak age of onset for type 1 diabetes is 12 years, but this is decreasing. In addition, there is an increasing incidence of diabetes in children and young people of four per cent per year in the UK. There is increased likelihood of type 1 diabetes occurring within families depending on the extent of shared human leukocyte antigen (HLA) genes.