Paediatric Diabetes
Emergency referrals
If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department or seek emergent medical advice if in a remote region.
It is proposed that the following conditions should be sent directly to emergency. This is not a list of all conditions that should be sent to the emergency department, it is intended as guidance for presentations that may otherwise have been directed to general paediatric outpatients:
Does your patient wish to be referred?
Minimum referral criteria
Does your patient meet the minimum referral criteria?
Category 1
Appointment within 30 days is desirable
- Suspected type 2 diabetes where:
- child/adolescent assessed to be well and without ketosis. Health care provider confident of type 2 diagnosis
- Unstable known type I diabetes transferring care
Category 2
Appointment within 90 days is desirable
- Stable known type 1 diabetic transferring care
Category 3
Appointment within 365 days is desirable
- No category 3 criteria
If your patient does not meet the minimum referral criteria
Consider other treatment pathways or an alternative diagnosis.
If you still need to refer your patient:
- Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
- Please note that your referral may not be accepted or may be redirected to another service
Other important information for referring practitioners
Not an exhaustive list
- To avoid delay in diagnosis, physicians need to take due care in their detection of diabetes in a patient and in defining its clinical sub‐type, since delayed diagnosis of type 1 diabetes in a child or adolescent is associated with an increased risk of DKA and subsequent morbidity and mortality
- In rural and remote areas it is preferable that local health professionals, who have access to the specialist paediatric diabetes team, provide ongoing support and education. If the child/adolescent/family is unable to access these health professionals, support with education should be provided by the experienced health professional at the provincial or tertiary diabetes centre, via videoconference or phone.
- Groups for whom inpatient management is necessary at diagnosis of type I diabetes include:
- individuals with diabetic ketoacidosis, significant comorbidities, inadequate social support or mental health issues
- children < 2 years of age
- those in geographically remote areas
- non-English speakers
- Refer to local/regional diabetes education/dietetic services. Registration with NDSS (national diabetes services scheme).
- Develop an individualised management plan which includes planned interaction with local caregivers, local health team and visiting specialists where necessary.
- If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, you need to contact Child Safety Services: https://www.communities.qld.gov.au/
Referral requirements
A referral may be rejected without the following information.
- General referral information
- History of the presentation including reasons why this is thought to be type 2 diabetes rather than type 1.(e.g. strong family history of type 2, obesity, evidence of insulin resistance [eg acanthosis nigricans])
- Report presence or absence of red flags
Presence of red flags
- Polyuria or polydipsia
- Recent weight loss
- Recent onset enuresis
- Ketosis on urine or blood testing
Investigations for suspected type 2 diabetes
- HbA1c FBC U&E LFT CRP TFT results
- Fasting plasma glucose and lipids results
- Ketones (blood or urine) – If positive send direct to emergencyNB: follow up/review patients will have pathology attended to in the clinic, the patient is not required to get blood tests prior to attending on an ongoing referral
Additional referral information (useful for processing the referral)
Highly desirable information – may change triage category
- Mode of presentation, whether insidious or acute
- Other past medical history
- Family history, especially of diabetes, Polycystic ovarian syndrome (PCOS) and other endocrine conditions
- Height/weight/head circumference and growth charts with prior measurements if available.
Desirable information — will assist at consultation
- Pregnancy and birth history
- Immunisation history
- Developmental history
- Medication history
- Allergies
- Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, department of child safety involvement)
- Other physical examination findings inclusive of CNS, birth marks or dysmorphology
- Any other relevant laboratory results or medical imaging reports
Out of catchment
Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can’t order, or the patient can’t afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
Send referral
Hotline: 1300 364 938
Fax: 1300 364 952
Electronic: eReferral system
Mail: Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
Access to Health Pathways is free for clinicians in Metro North Brisbane.
For login details email:
healthpathways
Login to Brisbane North Health Pathways:
brisbanenorth.