We discussed a young person – 15 year old with Type 1 diabetes for 8 years. Presenting with weight loss, abdominal pain and HBAIc 11.5 gm. RP by MF. SH took the hot seat and elicited a good history with very good communication skills, giving enough time for RP to respond and provide relevant information. Other observers chipped in with more details of social history, more exacting details of treatment.
- Do not forget to build rapport – ice breaker to start
- Phrase questions carefully and try to ask one at a time.
- Check why young person has come alone – may get clue to family dynamics
- Insulin – check dose iu, frequency, site, compliance
- Diet is important but do not get bogged down with detailed carbohydrate count
- Ask for information – DO Not assume.
- Good HEADSS screening
- Parents should be first line of support in management.
If I have missed any other points please add your comments.