Childhood diabetes: what the case manager needs to know

An 8-year-old girl arrives in the emergency room with a 10-day history of excessive thirst, frequent urination, and weight loss. Her blood sugar is 1000 mg/dL, with urine positive for glucose and ketones. A 14-year-old obese teenager also arrives with dark, thickened skin over his neck and a blood sugar level at 800 mg/dL, with normal urine. The first child has type 1 diabetes and the second type 2 diabetes. As case manager, it is your job to inform the patients and their families that the children have diabetes, see that they are taught basic management skills, and facilitate discharge from the hospital.