diabetestalk.net

Pediatric Dka Guidelines 2017

Managing Diabetes In Preschool Children Ispad Guidelines. Pediatric Diabetes. 2017;119.

Managing Diabetes In Preschool Children Ispad Guidelines. Pediatric Diabetes. 2017;119.

Managing diabetes in preschool children ISPAD Guidelines. Pediatric Diabetes. 2017;119. Frida Sundberg1,2 | Katharine Barnard3 | Allison Cato4 | Carine de Beaufort5,6 | Linda A DiMeglio7 | Greg Dooley8 | Tamara Hershey9,10 | Jeff Hitchcock11 | Vandana Jain12 | Jill Weissberg-Benchell13,14 | Birgit Rami-Merhar15 | The target hemoglobin A1c (HbA1c) for all children with type 1 diabetes, including preschool children, is recommended to be This target is chosen with the aim of minimizing hyperglycemia, severe hypoglycemia, hypoglycemic unawareness, and reducing the likelihood of development of long-term complications Intensive insulin therapy, i.e. as close to physiological insulin replacement as possible with preprandial insulin doses and basal insulin, should be used, with frequent glucose monitoring and Insulin pump therapy is the preferred method of insulin administration for young children (aged <7 years) with type 1 diabetes (E). If pump therapy is not available, multiple daily injections (MDIs), with consideration of use of an injection port, should be For preschool children using intensive insulin therapy, preprandial administration of bolus insulin given for correction if blood glucose is high and for at least part of the meal is preferable to giving the whole dose during or after the meal (C). Greg Dooley is parent of a child with type 1 diabetes diagnosed at age 2, cofounder of the type 1 diabetes blog Inspired by Isabella (www. inspiredbyisabella.com); Jeff Hitchcock is parent of a child with diabetes diagnosed at age 2, founder and president of Children with Diabetes (www. This article is a new chapter in the ISPAD Clinical Practice Consensus Guidelines Compendium. The complete set of guidelines can be found for free download at www.ispad.org. The evidence grad Continue reading >>

Pediatric Diabetic Ketoacidosis – Guideline From Royal Children’s Hospital Melbourne

Pediatric Diabetic Ketoacidosis – Guideline From Royal Children’s Hospital Melbourne

Our goal as primary care physicians is to make the diagnosis of Type 1 Diabetes or Diabetic Ketoacidosis at the earliest opportunity and then immediately arrange for inpatient expert follow up at a tertiary care center. Twenty-five percent of patients with a new diagnosis of diabetes present with diabetic ketoacidosis; a missed diagnosis of diabetes is the most common cause, especially in young children. [from Pediatric Diabetic Ketoacidosis Emergency Department Care of emedicine.medscape.com] What follows are excerpts of Pediatric Type 1 Diabetes Mellitus Clinical Presentation Updated: Apr 27, 2017 from emedicine.medscape.com: Symptoms of ketoacidosis These symptoms include the following: What follows are only excerpts from the Diabetes Mellitus Guideline. Please see the complete protocol] on diabetic ketoacidosis from the Royal Children’s Hospital Melbourne: Background: Diabetic ketoacidosis (DKA) is the combination of hyperglycemia, metabolic acidosis, and ketonaemia. It may be the first presentation for a child with previously undiagnosed diabetes. It can also be precipitated by illness, or poor compliance with taking insulin. All patients presenting with a blood glucose level (BGL) ≥ 11.1mmol/l [200 mg/dl] should have blood ketones tested on a capillary sample using a bedside OptiumTM meter. If this test is positive (>0.6 mmol/l), assess for acidosis to determine further management. Urinalysis can be used for initial assessment if blood ketone testing is not available. The biochemical criteria for DKA are: 1. Venous pH < 7.3 or bicarbonate <15 mmol/l 2. Presence of blood or urinary ketones If ketones are negative, or the pH is normal in the presence of ketones, patients can be managed with subcutaneous (s.c.) insulin (see ‘ new presentation, mildly ill‘ bel Continue reading >>

Children's Hospital Of Philadelphia

Children's Hospital Of Philadelphia

If you have questions about any of the clinical pathways or about the process of creating a clinical pathway please contact us. ©2017 by Children's Hospital of Philadelphia, all rights reserved. Use of this site is subject to the Terms of Use. The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located. Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient. Continue reading >>

Adherence To Pediatric Diabetic Ketoacidosis Guidelines By Community Emergency Departments Providers

Adherence To Pediatric Diabetic Ketoacidosis Guidelines By Community Emergency Departments Providers

Adherence to pediatric diabetic ketoacidosis guidelines by community emergency departments providers 2Department of Pediatrics, Section of Pediatric Hospital Medicine, Indiana University School of Medicine and Riley Hospital for Children at Indiana University Health, 705 Riley Hospital Drive, ROC 4905, Indianapolis, IN 46202-5225 USA 1Section of Pediatric Critical Care Medicine, Indianapolis, IN USA 2Department of Pediatrics, Section of Pediatric Hospital Medicine, Indiana University School of Medicine and Riley Hospital for Children at Indiana University Health, 705 Riley Hospital Drive, ROC 4905, Indianapolis, IN 46202-5225 USA Samer Abu-Sultaneh, Phone: 317-948-7185, Email: [email protected] . Received 2017 Jan 4; Accepted 2017 Mar 14. Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Diabetic ketoacidosis (DKA) is a common presentation of type I diabetes mellitus to the emergency departments. Most children with DKA are initially managed in community emergency departments where providers may not have easy access to educational resources or pediatric-specific guidelines and protocols that are readily available at pediatric academic medical centers. The aim of this study is to evaluate adherence of community emergency departments in the state of Indiana to the pediatric DKA guidelines. We performed a retrospective chart review of patients, age 18 years of age or under, admitted to the pediatric intensive care unit with a diagnosis of DKA. A total of 100 patients w Continue reading >>

M A N A G E M E N T A N D T R E A T M E N T O F

M A N A G E M E N T A N D T R E A T M E N T O F

This care process model (CPM) was developed by Intermountain Healthcare’s Pediatric Clinical Specialties Program. It provides guidance for identifying and managing type 1 diabetes in children, educating and supporting patients and their families in every phase of development and treatment, and preparing our pediatric patients to transition successfully to adulthood and adult diabetes self-management. This CPM is based on guidelines from the American Diabetes Association (ADA), particularly the 2014 position statement Type 1 Diabetes Through the Life Span, as well as the opinion of local clinical experts in pediatric diabetes.ADA1,CHI Pediatric Type 1 Diabetes C a r e P r o c e s s M o d e l F E B R U A R Y 2 0 1 7 2 0 17 U p d a t e Why Focus on PEDIATRIC TYPE 1 DIABETES? Diabetes in childhood carries an enormous burden for patients and their families and represents significant cost to our healthcare system. In 2008, Intermountain Healthcare published the first CPM on the management of pediatric diabetes with the overall goal of helping providers deliver the best clinical care in a consistent and integrated way. What’s new: • Separate CPMs for type 1 and type 2 pediatric diabetes to promote more- accurate diagnosis and more-focused education and treatment. • Updated recommendations for diagnostic testing, blood glucose control, and follow-up care specifically related to pediatric type 1 diabetes. • A more comprehensive view of treatment for pediatric type 1 diabetes — one that emphasizes psychosocial wellness for patient and family and lays a foundation for better health over the lifespan. • Information and tools to support pediatric type 1 diabetes care by nonspecialist providers — important for coping with the ongoin Continue reading >>

Episode 63 – Pediatric Dka

Episode 63 – Pediatric Dka

Pediatric DKA was identified as one of key diagnoses that we need to get better at managing in a massive national needs assessment conducted by the fine folks at TREKK – Translating Emergency Knowledge for Kids – one of EM Cases’ partners who’s mission is to improve the care of children in non-pediatric emergency departments across the country. You might be wondering – why was DKA singled out in this needs assessment? It turns out that kids who present to the ED in DKA without a known history of diabetes, can sometimes be tricky to diagnose, as they often present with vague symptoms. When a child does have a known history of diabetes, and the diagnosis of DKA is obvious, the challenge turns to managing severe, life-threatening DKA, so that we avoid the many potential complications of the DKA itself as well as the complications of treatment – cerebral edema being the big bad one. The approach to these patients has evolved over the years, even since I started practicing, from bolusing insulin and super aggressive fluid resuscitation to more gentle fluid management and delayed insulin drips, as examples. There are subtleties and controversies in the management of DKA when it comes to fluid management, correcting serum potassium and acidosis, preventing cerebral edema, as well as airway management for the really sick kids. In this episode we‘ll be asking our guest pediatric emergency medicine experts Dr. Sarah Reid, who you may remember from her powerhouse performance on our recent episodes on pediatric fever and sepsis, and Dr. Sarah Curtis, not only a pediatric emergency physician, but a prominent pediatric emergency researcher in Canada, about the key historical and examination pearls to help pick up this sometimes elusive diagnosis, what the value of serum Continue reading >>

Acute Kidney Injury In Children With Type 1 Diabetes Hospitalized For Diabetic Ketoacidosis

Acute Kidney Injury In Children With Type 1 Diabetes Hospitalized For Diabetic Ketoacidosis

Questions What proportion of pediatric patients with type 1 diabetes who present in diabetic ketoacidosis develop acute kidney injury, and what are the associated risk factors? Findings In this medical record review of 165 children with type 1 diabetes who were hospitalized for diabetic ketoacidosis, 106 (64.2%) met the criteria for acute kidney injury. Serum bicarbonate level less than 10 mEq/L and an elevated heart rate were found to be associated with an increased risk of severe acute kidney injury. Meaning Children in diabetic ketoacidosis are at high risk for acute kidney injury, suggesting that clinicians should consider acute kidney injury as a frequent complication in this population. Importance Acute kidney injury (AKI) in children is associated with poor short-term and long-term health outcomes; however, the frequency of AKI in children hospitalized for diabetic ketoacidosis (DKA) has not been previously examined. Objectives To determine the proportion of children hospitalized for DKA who develop AKI and to identify the associated clinical and biochemical markers of AKI. Design, Setting, and Participants This medical record review of all DKA admissions from September 1, 2008, through December 31, 2013, was conducted at British Columbia Children’s Hospital, the tertiary pediatric hospital in British Columbia, Canada. Children aged 18 years or younger with type 1 diabetes and DKA and with complete medical records available for data analysis were included (n = 165). All data collection occurred between September 8, 2014, and June 26, 2015. Data analysis took place from August 25, 2015, to June 8, 2016. Main Outcomes and Measures Acute kidney injury was defined using Kidney Disease/Improving Global Outcomes serum creatinine criteria. Multinomial logistic regress Continue reading >>

Dka Management In Children: Ada

Dka Management In Children: Ada

Diabetic ketoacidosis (DKA) is considered to be a common presentation of Type 1 Diabetes Mellitus (T1DM) and occasionally, Type 2 Diabetes Mellitus (T2DM) in children and adolescents. DKA arises due to lack of adequate insulin in the body. Clinical Signs Dehydration (may be difficult to assess) Tachycardia, tachypnoea (may be mistaken for pneumonia or asthma) Kussmaul breathing with a typical fruity smell of ketones in the breath Nausea, vomiting (may be mistaken for gastroenteritis) Abdominal pain (may mimic an acute abdominal condition) Confusion, drowsiness, progressive reduction in level of consciousness, and eventually loss of consciousness. Investigations Serum glucose >200 mg/dL Serum bicarbonate <15 mEq/L or venous pH <7.3 Reduction in serum sodium of 2.4 mEq/L for every 100 mg/dL Potassium losses of 6–7 mEq/kg Negative phosphate balance Creatinine, BUN, blood gases, and hematocrit Blood Beta-hydroxybutyrate ≥31 mg/dL Urinalysis (for ketones) Electrocardiogram (ECG), if laboratory measurement of potassium status is delayed Diagnosis ISPAD in 2014 has defined the following biochemical criteria for the diagnosis of DKA: Hyperglycemia, blood glucose of >200 mg/dL, Metabolic acidosis, defined as a venous pH <7.3 or plasma bicarbonate <15 mEq/L, and Ketosis Severity of DKA: mild, moderate, or severe (pH 7.2–7.3; pH 7.1–7.2; or pH <7.1, respectively) Treatment Principles of DKA treatment: Replacement of fluid deficits Correction of dehydration Correction of acidosis and hyperglycemia Correction of electrolyte imbalance Treatment of any precipitating cause a. Fluid therapy: 0.9% normal saline or Ringer’s lactate, 10 mL/kg normal bolus for 1–2 hr. Continue ½ NS for 4–6 hr When the child becomes stable, switch to oral fluids After the first 48 hr, fluid ad Continue reading >>

Pediatric Diabetic Ketoacidosistreatment & Management

Pediatric Diabetic Ketoacidosistreatment & Management

Pediatric Diabetic KetoacidosisTreatment & Management Author: William H Lamb, MD, MBBS, FRCP(Edin), FRCP, FRCPCH; Chief Editor: Timothy E Corden, MD more... In patients with diabetic ketoacidosis, the first principals of resuscitation apply (ie, the ABCs [airway, breathing, circulation]). [ 3 ] Outcomes are best when children are closely monitored and a changing status is promptly addressed. [ 39 , 2 ] Give oxygen, although this has no effect on the respiratory drive of acidosis. Diagnose by clinical history, physical signs, and elevated blood glucose. Fluid, insulin, and electrolyte (potassium and, in select cases, bicarbonate) replacement is essential in the treatment of diabetic ketoacidosis. Early in the treatment of diabetic ketoacidosis, when blood glucose levels are very elevated, the child can continue to experience massive fluid losses and deteriorate. Strict measurement of fluid balance is essential for optimal treatment. Continuous subcutaneous insulin infusion therapy using an insulin pump should be stopped during the treatment of diabetic ketoacidosis. Children with severe acidosis (ie, pH < 7.1) or with altered consciousness should be admitted to a pediatric intensive care unit. In cases in which the occurrence of diabetic ketoacidosis signals a new diagnosis of diabetes, the process of education and support by the diabetes team should begin when the patient recovers. In cases in which diabetic ketoacidosis occurs in a child with established diabetes, explore the cause of the episode and take steps to prevent a recurrence. Following recovery from diabetic ketoacidosis, patients require subcutaneous insulin therapy. Edge JA, Roy Y, Bergomi A, et al. Conscious level in children with diabetic ketoacidosis is related to severity of acidosis and not to blood g Continue reading >>

Cerebral Edema And Diabetic Ketoacidosis

Cerebral Edema And Diabetic Ketoacidosis

Cerebral edema is the most feared emergent complication of pediatric diabetic ketoacidosis. Fortunately, it is relatively rare, but the rarity can lead to some confusion when it comes to its management. We recently discussed the use of mannitol and hypertonic saline for pediatric traumatic brain injury, but when should we consider these medications for the patient presenting with DKA? Cerebral Edema is a relatively rare. Incidence <1% of patients with DKA. Overall tends to occur in the newly diagnosed diabetic patient (4.3% vs 1.2%). While rare, it is a devastating complication. 1990 study showed case fatality rate was 64%. Those treated BEFORE respiratory failure had lower rate of mortality (30%). Lesson = treat early! The exact mechanism is not known… and may be varied between individual patients. Signs and Symptoms develop in: 66% within the first 7 hours of treatment (these tend to be younger). 33% within 10-24 hours of treatment. The diagnosis is clinical! ~40% of initial brain imaging of kids with cerebral edema are NORMAL! This is the area that often leads to finger pointing… most often those fingers being pointed toward the Emergency Physician who was initially caring for the kid. Much of the literature focused on interventions, but: Administration of Bicarb Sodium Bicarb was shown to be associated with Cerebral Edema in one study… Unfortunately, this study did not adjust for illness severity. Type of IV Fluids Generally, there is an absence of evidence that associates volume, tonicity, or rate change in serum glucose with Cerebral Edema development. There are cases presenting with cerebral edema prior to any therapies. Risk Factors that seem to stay consistent: Kids < 5 years of age More likely to have delayed diagnosis More severely ill at presentation S Continue reading >>

Emdocs.net Emergency Medicine Educationa Well-grounded Myth? The Association Of Iv Fluids With Cerebral Edema In Pediatric Dka - Emdocs.net - Emergency Medicine Education

Emdocs.net Emergency Medicine Educationa Well-grounded Myth? The Association Of Iv Fluids With Cerebral Edema In Pediatric Dka - Emdocs.net - Emergency Medicine Education

A Well-Grounded Myth? The Association of IV Fluids with Cerebral Edema in Pediatric DKA Author: Brit Long, MD (@long_brit, EM Attending Physician at SAUSHEC, USAF) // Edited by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UT Southwestern Medical Center / Parkland Memorial Hospital) A 5-year-old little girl presents with vomiting, polyuria, and polydipsia. She has a history of type 1 diabetes on insulin. Her mom called her endocrinologist, who recommended they come in to the ED. Her vital signs demonstrate tachycardia and hypotension, and she appears ill. You order a VBG, urinalysis, CBC, renal function, and lactate, and while you consider your rehydration strategy, the endocrinologist calls and asks you to do maintenance therapy only. The patient looks ill, with hemodynamic abnormalities. Whats the literature behind cerebral edema (CE) and fluid rehydration in pediatric DKA? This post will evaluate this topic and more. Type 1 and 2 diabetes mellitus is a common chronic disease among children.1-5 A major complication is DKA with a 25% incidence.3-8 Almost 1/3 of patients have DKA at the time of initial diabetes diagnosis.3-7 Younger age, smaller body mass index, delayed treatment, infectious trigger, and lack of health insurance are risk factors for DKA.1,2,8 Even type 2 diabetics may experience DKA, with 5-25% of patients in DKA at time of diagnosis of type 2 diabetes.4,8,9 Insulin omission and infection are the most common sources for DKA.1,2 Pediatric DKA consists of hyperglycemia (serum glucose greater than 200 mg/dL), anion gap metabolic acidosis, and ketonemia.1,10-14 DKA is due to absolute or relative deficiency in insulin and excess counterregulatory hormones, with dehydration and electrolyte abnormalities. Rehydration with fluids, insulin, and potentia Continue reading >>

Treatment And Complications Of Diabetic Ketoacidosis In Children And Adolescents

Treatment And Complications Of Diabetic Ketoacidosis In Children And Adolescents

INTRODUCTION Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (T1DM), with a case fatality rate ranging from 0.15 percent to 0.31 percent [1-3]. DKA also can occur in children with type 2 DM (T2DM); this presentation is most common among youth of African-American descent [4-8]. (See "Classification of diabetes mellitus and genetic diabetic syndromes".) The management of DKA in children will be reviewed here (table 1). There is limited experience in the management and outcomes of DKA in children with T2DM, although the same principles should apply. The clinical manifestations and diagnosis of DKA in children and the pathogenesis of DKA are discussed elsewhere. (See "Clinical features and diagnosis of diabetic ketoacidosis in children and adolescents" and "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Epidemiology and pathogenesis".) DEFINITION Diabetic ketoacidosis – A consensus statement from the International Society for Pediatric and Adolescent Diabetes (ISPAD) in 2014 defined the following biochemical criteria for the diagnosis of diabetic ketoacidosis (DKA) [9]: Hyperglycemia – Blood glucose of >200 mg/dL (11 mmol/L) AND Metabolic acidosis – Venous pH <7.3 or a plasma bicarbonate <15 mEq/L (15 mmol/L) AND Continue reading >>

Pem Pearls: Treatment Of Pediatric Diabetic Ketoacidosis And The Two-bag Method

Pem Pearls: Treatment Of Pediatric Diabetic Ketoacidosis And The Two-bag Method

Insulin does MANY things in the body, but the role we care about in the Emergency Department is glucose regulation. Insulin allows cells to take up glucose from the blood stream, inhibits liver glucose production, increases glycogen storage, and increases lipid production. When insulin is not present, such as in patients with Type 1 diabetes mellitus (DM), all of the opposite effects occur. A lack of insulin causes the following downstream effects: Prevents glucose from being used as an energy source – Free fatty acids are used instead and produce ketoacids during metabolism. Causes a surge of stress hormones and induces gluconeogenesis – When blood glucose levels are elevated, the kidneys cannot absorb all of the glucose from the urine, and the extra glucose in the urine causes polyuria, even in the setting of dehydration. In addition, acidosis causes potassium to shift out of cells into the blood, and the combination of this with dehydration causes the body to preferentially retain sodium at the expense of potassium.1,2 When insulin homeostasis is disrupted and decompensates, patients are at risk for developing diabetic ketoacidosis (DKA). All of the following criteria are required for a diagnosis of DKA: Hyperglycemia (glucose >200 mg/dL) Acidosis (pH <7.3 or bicarb <15 mmol/L) Ketosis (by urine or blood test) Treatment is based on a simple principle: return the body’s glucose regulation to its normal state and replace all of the things the body consumed while insulin-deficient. While bolus insulin is common in the treatment of DKA in adults, it is relatively contraindicated in the pediatric patient. Dehydration and secondary sympathetic activation can interfere with local tissue perfusion and may cause irregular and unpredictable absorption. Step 1: Correction Continue reading >>

Diabetic Ketoacidosis In Children And Adolescents Raghupathy P - Indian J Endocr Metab

Diabetic Ketoacidosis In Children And Adolescents Raghupathy P - Indian J Endocr Metab

Diabetic ketoacidosis (DKA) is considered to be a common presentation of type 1 diabetes mellitus (T1DM) and occasionally, type 2 diabetes mellitus (T2DM) in children and adolescents. DKA arises due to lack of adequate insulin in the body. Insulin stops the use of fat as an energy source by inhibiting the peptide hormone glucagon. Without insulin, glucagon levels rise resulting in the release of free fatty acids from adipose tissue, as well as amino acids from muscle cells. The biochemical criteria for DKA diagnosis include hyperglycemia (blood glucose [BG] higher than 11 mmol/L or 200 mg/dL) with a venous pH of <7.3 and/or a bicarbonate (HCO 3 ) level of <15 mmol/L; ketonemia and ketonuria. Although not universally available, blood -hydroxybutyrate concentration should be measured whenever possible, and a level of 3 mmol/L is indicative of DKA. Urine ketones, of moderate or large size (typically 2+), are also indicative of DKA. The clinical signs of DKA include dehydration (may be difficult to detect), tachycardia, tachypnoea (may be mistaken for pneumonia or asthma), deep sighing (Kussmaul) respiration with a typical smell of ketones in the breath (variously described as the odor of nail polish remover or rotten fruit), nausea, vomiting (may be mistaken for gastroenteritis), abdominal pain (may mimic an acute abdominal condition), confusion, drowsiness, progressive reduction in level of consciousness, and eventually loss of consciousness. Risk factors for DKA in newly diagnosed cases include younger age (<2 years), delayed diagnosis, and lower socioeconomic status with limited access to medical services. Risk factors for DKA in patients with known diabetes include insulin omission, poor metabolic control, previous episodes of DKA, acute gastroenteritis with persisten Continue reading >>

Ispad Clinical Practice Consensus Guidelines 2014

Ispad Clinical Practice Consensus Guidelines 2014

Editor in Chief: Mark A. Sperling, Pittsburgh, USA. Guest Editors: Carlo Acerini, Maria E Craig, Carine de Beaufort, David M Maahs and Ragnar Hanas. Introduction Carlo Acerini, Maria E Craig, Carine de Beaufort, David M Maahs and Ragnar Hanas. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 1–3. Uploaded: 2. Sept 2014 Download Introduction Chapter 1: Definition, epidemiology, diagnosis and classification Craig ME, Jefferies C, Dabelea D, Balde N, Seth A, Donaghue KC. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 4–17. Uploaded: 2. Sept 2014 Download Chapter 1 Chapter 2: Phases of Type 1 Diabetes Couper JJ, Haller MJ, Ziegler A-G, KnipM, Ludvigsson J, Craig ME. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 18–25. Download Chapter 2 Chapter 3: Type 2 diabetes Zeitler P, Fu J, Tandon N, Nadeau K, Urakami T, Bartlett T, Maahs D. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 26-46. Uploaded: 2. Sept 2014 Download Chapter 3 Chapter 4: The Diagnosis and Management of Monogenic diabetes Rubio-Cabezas O, Hattersley AT, Njølstad PR, Mlynarski W, Ellard S,White N, Chi DV, Craig ME. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 47-64. Uploaded: 2. Sept 2014 Download Chapter 4 Chapter 5: Management of cystic fibrosis-related diabetes Moran A, Pillay K, Becker DJ, Acerini CL. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 65-76. Uploaded: 2. Sept 2014 Download Chapter 5 Chapter 6: Diabetes education Lange K, Swift P, Pankowska E, Danne T. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 77-85. Uploaded: 2. Sept 2014 Download Chapter 6 Chapter 7: The delivery of ambulatory diabetes care Pihoker C, Forsander G, Fantahun B, Virmani A, Luo X, Hallman M, Wolfsdorf J, Maahs DM. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 86-101. Up Continue reading >>

More in ketosis