Introduction

Introduction

This online book is intended to be a self-guided resource for medical students and residents at the University of Iowa Stead Family Children’s Hospital caring for hospitalized pediatric patients with diabetes mellitus.  This resource was created based on results from a targeted needs assessment of pediatric residents, calling for a more standardized, up-to-date resource about diabetes management. It was also created to meet the perceived needs of the pediatric endocrinology faculty that more standardized education regarding routine inpatient diabetes mellitus management for our learners is needed to ensure that:

  1. We are providing an opportunity to learn the management of a complex and chronic endocrine-related illness that will be encountered by all physicians, no matter what future field of medicine they will practice.
  2. Our learners provide the highest level of safe, quality care to hospitalized patients with diabetes mellitus according to best practices, standards of care, and our local institutional protocols.

Unfortunately, with the time allotted for pediatric endocrinology for rounds (15 minutes per day) and inconsistent didactic lectures, teaching regarding inpatient pediatric diabetes mellitus has been fragmented. Therefore, this resource is intended to fill gaps in knowledge that may not be fully covered during these intermittent opportunities for education.

All learners who use this resource are encouraged to review the content in full.  At the end of each Chapter, learners are encouraged to complete the end-of-chapter questions to test their understanding and application of the information.

By completing the full contents of this resource, learners should be able to:

  1. Differentiate between Type 1 and Type 2 diabetes mellitus and their respective presentations, initial work-up, diagnosis, and initial management.
  2. Recognize the most common types of insulin utilized in the inpatient setting.
  3. Differentiate between types of insulin based on their pharmacokinetic profiles.
  4. Perform basic calculations necessary to generate an initial basal-bolus insulin regimen for new-onset diabetic patients while using appropriate terminology when discussing these insulin regimens.
  5. Make appropriate recommendations for adjustment of insulin regimens based on blood glucose trends to work toward achieving goals of treatment.
  6. Describe and apply basic nutritional concepts pertinent to inpatient management of diabetes mellitus.
  7. Apply knowledge of the University of Iowa Stead Family Children’s Hospital’s pediatric diabetes protocols for the routine management of common issues in hospitalized pediatric diabetes patients, including hypoglycemia, hyperglycemia, and ketonuria.

We hope you enjoy using this resource. We welcome any feedback on suggestions on how to improve this resource for you and future learners.

Please send feedback to Dr. Alex Tuttle, alexander-tuttle@uiowa.edu. 

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