According to the Australian Institute of Health and Welfare, Australia spent 10.3% of its Gross Domestic Product on healthcare in 2015-16. That pays for an impressive bit of infrastructure geared to identify, diagnose and treat acute and chronic health conditions like those associated with diabetes.
At the same time, there were 307,000 nurses and 88,000 doctors working in the health system. Each and everyone of them went through a university system and are regulated to maintain the quality of their knowledge and skills to deliver quality healthcare.
Wouldn’t you think that this kind of investment would ensure that people with type 1 diabetes are diagnosed before they become critically unwell or die?
Unfortunately, it would seem not, as Diabetes Australia highlighted this week (#DAW2018) that one in five people diagnosed with type 1 diabetes (that’s 640 people!) are sick enough to end up in hospital each year because the signs and symptoms of type 1 diabetes are missed by their doctors. What we don’t know is how many die before their diagnosis could be made. It is important that we start to track just how many people do die in Australia from missed type 1 diagnosis … but – one is too many.
It’s About Time … no-one dies because of a Type 1 diabetes diagnosis miss.
Jayne’s Top #5 Hacks to diagnosing Type 1 Diabetes (T1D) for doctors and nurses across Australia:
1. When someone presents to the GP or Accident and Emergency with abdominal pain and vomiting, always ask if they have the 4T symptoms of T1D … Tired…Thinner …Toilet (wee) … Thirsty … and do a BGL check. DKA often presents with abdo pain and/or vomiting which can be a red herring in diagnosing to further delay, potentially fatally, their diagnosis of T1D.
2. If you suspect diabetes … always do a cautionary check of urine or blood for ketones – especially if weight loss has occurred. If positive for ketones, assume T1D until proven otherwise and check for DKA. Same applies in someone with T2D who needs higher doses of oral medication early. Check their ketones as may have been misdiagnosed and actually have T1D.
3. When so many doctors and nurses wrongly say a person with type 2 diabetes is ‘insulin dependent’ if they start insulin, then undergraduate and postgraduate medicine and nursing curriculums need to improve. At least let’s get the diagnosis right people! They still have type 2 diabetes but it is insulin requiring – and low risk for DKA.
4. Age doesn’t define the type of diabetes a person is likely to have – people of any age can develop type 1 diabetes. Always check for ketones when people present with the 4Ts of T1D.
5. Keep your diabetes diagnosis and management knowledge and skills up to date and there won’t be a missed diagnosis of T1D on your watch.
Why not read Frank (photographed with me to the left at the ADS/ADEA Annual Scientific Meeting 2017 in Perth!) and Bec’s experiences of being diagnosed with their type 1 diabetes? Click here!
Check out the Diabetes Awareness Week 2018 campaign here.
Go to Jayne’s website to read more like this.