Syllabus for the SpR in paediatric diabetes
This document should act as a framework for specialist registrars
training in paediatric diabetes. Doctors should feel reasonably
well-equipped to run a children’s diabetes service when
the various components have been addressed. This is likely to
take between one and two years although the duration will depend
upon the nature and intensity of the training obtained.
Aims and objectives of the attachment
- To achieve an understanding of the broad based, multifaceted
nature of diabetes care.
- To gain experience of working in a multi-disciplinary team.
- To appreciate the purpose and logistics of running a diabetes
clinic.
- To understand the nature and effect of diabetes, a chronic
illness, on children and families.
- To understand the element of partnership with families in
the management process and to recognise when this is faltering.
- To appreciate the elements of the education process.
- To understand the biochemical basis of diabetes.
- To be familiar with the various forms of diabetes in young
people and the key differences between them. This includes types
I and II diabetes, MODY and diabetes in pateints with illness’s
such as cystic fibrosis.
- To gain experience of diabetes at different ages.
- To gain experience of the various insulin preparations, regimens
and their potential advantages and disadvantages
- To be familiar with different glucose monitors and insulin
delivery systems.
- To gain experience and an understanding of the effects of
illness and exercise.
- To clearly understand the assessment and management of DKA.
- To understand the management of cerebral oedema
- To clearly understand the aetiology and the management of
hypoglycaemia.
- To be able to manage other ‘emergencies’ such
as a missed or incorrect insulin dose.
- To clearly understand the management of diabetes at the time
of surgery.
- To be familiar with the long term complications of diabetes
and their relationship to factors such as glycated haemoglobin
concentrations.
- To be familiar with the different approaches to the detection
of complications and to be aware of their limitations.
- To be able to conduct an annual review.
- To experience the process of audit with reference to diabetes.
Learning activities
- Sit in with consultants.
- Attachment to Diabetes specialist nurse for hospital and home
visits.
- Attachment to the paediatric dietician for one or more clinics
- Attachment to biochemistry department to learn about HbA1c
assay.
- Visit one other diabetes clinic.
- Attend visual screening session.
- Attachment to adult diabetes clinic at least once each month.
- Attachment to adult eye clinic.
- Take part and run an education session.
- To undertake an audit project.
- To attend a ‘diabetes holiday’.
- Review computer education packages for children.
- To attend and contribute to clinic/team meetings
- Attendance at diabetes interest groups.
- Case presentations.
- Journal club presentations.
- Audit presentation.
- Self directed learning.
Literature
*Pickup JC, Williams G. Textbook of diabetes. Blackwell Scientific
Publication, Oxford,
*Kelnar CJ. Textbook of childhood and adolescent diabetes. Chapman
Hall, London.
*Court & Lamb. Textbook of childhood and adolescent diabetes.
Wiley, 1997.
*Alberti et al. International Textbook of Diabetes Mellitus.
Wiley, 1997.
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