The care of 16-18 year olds presenting with DKA is fraught with difficulty. Whilst they may have their outpatient care in the children and young persons department, if they are admitted to hospital, their care maybe delivered by a number of different teams – adult or paediatrics, who may or may not have a specialist interest in diabetes.
The most commonly used guidelines in the UK are produced by the JBDS, but these specifically state they should only be used for those over 18 years old. The guidelines for those under 18 are produced by BSPED. However, it is unknown whether those who are 16-18 years old are treated appropriately.
That is the purpose of this questionnaire.
It is designed to be filled out by those ‘at the front door’ – i.e. junior doctors or nurses in A&E or the acute medical units – be it adult or paediatric - who look after people with DKA within the first hour of initial presentation. It could also be filled out by the nursing staff if they are involved in their care
This is joint collaboration with adult and paediatric teams. Depending on the results of this questionnaire, it may well lead to the development of a unified DKA guideline for adults and children.
Please pass this email on to whoever you think will be best to give this the right junior – it could be the senior nurse in adult A&E / Acute medical unit or in the paediatric emergency area, or paediatric acute assessment unit. It could be the clinical lead for adult or paediatric diabetes to pass on to the juniors in the emergency areas.
We want to get as many replies as possible to get an understanding of the current state of affairs for this potentially vulnerable group of individuals.
Please ask them to fill in the questionnaire HERE and TOGETHER WITH A COPY OF THE DKA GUIDELINE USED FOR 16-18 YEAR OLDS IN YOUR TRUST either email it back to me at
or to put it in the post to me at
Dr Ketan Dhatariya
Consultant in diabetes, endocrinology and general medicine
Hon Reader in Medicine, University of East Anglia
Elsie Bertram Diabetes Centre
Norfolk and Norwich University Hospitals NHS Foundation Trust
Colney Lane
Norwich
NR4 7UY
