Question of the Week | New diabetes at 13, best next step?

MR is 13 years old, and went to urgent care because they weren’t feeling well and told the Provider “I feel so tired all the time and I have to go the bathroom a lot”.  The provider draws labs and gets a urine sample. The A1C is 8.7% with some ketones in the urine.  The antibody results aren’t back yet.  Based on the ADA Standards and this information, what is the best action?

  1. Start MR on basal insulin
  2. Order a nutrition consult ASAP and provide MR with a meter
  3. Initiate GLP-1 therapy to help lower glucose and A1C
  4. Start metformin therapy, then add exenatide XR if needed

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This course includes updated goals and guidelines for children living with type 1 or type 2 diabetes. This course discusses the special issues diabetes educators need to be aware of when working with children with diabetes and their families.  We discuss the clinical presentation of diabetes, goals of care, and normal growth and development through the early years through adolescence. Strategies to prevent acute and long term complications are included with an emphasis on positive coping for family and child with diabetes.

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