The primary care pediatric nurse practitioner diagnoses an 8-year-old child with type 1 diabetes after a routine urine screen is positive for glucose and negative for ketones and plasma glucose is 350 mg/dL. The child's weight is normal and the parents report a mild increase in thirst and urine output in the past few days. Which course of action is correct?

Question

Quizplus · Accepted Answer

The child should begin insulin therapy and be referred to a children's diabetes center for ongoing management. A plasma glucose level of 350 mg/dL is consistent with a diagnosis of type 1 diabetes, and the absence of ketones suggests that the child is not in diabetic ketoacidosis (DKA). Hospitalization is not necessary for insulin initiation in a stable child with new-onset type 1 diabetes. A fasting serum glucose and UA in the morning may help to confirm the diagnosis, but treatment should not be delayed for these tests. Sending the child to the emergency department is not necessary as the child is stable and not in DKA.

The Primary Care Pediatric Nurse Practitioner Diagnoses an 8-Year-Old Child