Adult Type 1 Diabetes

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to referral standards and include in particular:

  • Onset of condition including glycosuria, nocturia, polyuria, polydipsia, polyphagia
  • History of weight loss, malaise, fatigue
  • History of predisposing features: haemochromatosis, autoimmune disorders, cultural group, obesity, inactivity, hypertension
  • Obstetric history of macrosomia or gestational diabetes,
  • Medications causing hyperglycaemia
  • Risk factors for complications: smoking, pre-existing skin disease or cardiovascular disease
  • Occupational issues: pilots, bus drivers
  • Examination should include BMI, waist circumference, blood pressure, pedal sensation and circulation 
  • Urinalysis including ketones

NB: Pregnant patients need early referral to Antenatal Endocrine Clinic

Tests

  • HbA1c
  • Fasting lipid profile
  • Urea, Electrolytes & Creatinine, eGFR
  • Liver function tests
  • Urine ACR
  • ECG, if >50 years old and at least one other vascular risk factor or for driver's licence assessment
  • Thyroid function tests – if indicated

Interim/GP management

To refer a patient with this condition, please see the Diabetes clinic page for the full referral process and templates.

Ensure good hydration.

See the RACGP guidelines for diabetes management in General Practice.

Direct link to Health Pathways Type 1 Diabetes page

For more information please see the Tasmanian Health Pathways website.

Emergency

Diabetes with ketoacidosis

Urgent / category 1

New onset

Semi-urgent / category 2

Difficult to manage symptoms or treatment

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Driver's licence medical examinations for commercial licence for patients with type 1 diabetes will be accepted but will be categorised as Category 3.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment