Improving Patient Care and Quality of Life Through Technological Innovations – Type 1 Diabetes Management SOAP D.O. is a ten-year-old male Caucasian who has been brought to the hospital by her mother with complaints of weight loss and bed wetting. D.O.’s mother highlights that D.O. has lost 5 kgs in the past two weeks

. She has noticed that D.O. consumes more food and is always hungry; therefore, she does not know how he continues to lose weight despite his eating pattern. D.O.’s mother explains that he has been toilet trained, yet he began bed-wetting one month ago. She restricts the number of fluids, such as water and juice, that D.O. takes in the evening and at night to prevent bed wetting without any success. She ensures that D.O. visits the washroom for urination before bedtime, yet he still wets the bed. D.O.’s mother and teachers have noticed changes in his behaviour. The school report states that D.O. is highly irritable and fights with other children.

D.O. is lactose intolerant and has no known allergy to any medication. He was last hospitalized for an open reduction internal surgery in 2020 when he fell during playtime at school. D.O.’s immunization is up to date. However, he has not been vaccinated against COVID-19. His last eye and dental examination were done six months ago. D.O. is in grade 5 at the neighbouring school. He lives with his father, mother, 15-year-old sister, and paternal grandmother. D.O.’s sister and mother are in good health. His father and paternal grandmother are known people with diabetes. D.O.’s paternal grandfather died in a road traffic accident. His maternal grandfather is a known hypertensive, while his maternal grandmother has dementia. D.O.’s parents ensure he lives a healthy life by eating a well-balanced diet and participating in physical activities such as sports. He has been exposed to surroundings where people take alcohol and smoke, but he is aware of the adverse effects of drugs and does not use recreational drugs. He actively participates in sports and loves cycling with his friends.

The patient’s general and endocrinology review of systems shows weight loss. A review of the genitourinary system reveals increased urination and bed wetting, while the gastrointestinal system reveals increased appetite. The patient is irritable but denies depression, a history of suicidal thoughts, anxiety, bipolar disorder, confusion, problems with memory and concentration, or any other mental health problem. Physical assessment reveals dry skin, pale eyes, cold hands and feet, and sunken eyes, which are signs of dehydration. Tests for vital signs showed a weight of 30kgs, blood pressure of 95/65 mmHg, a height of 137cm,  BMI of 16, respiratory rate of 26 breaths per minute, pulse rate of 90 beats per minute, a body temperature of 37C, and oxygen saturation of 99%. Although D.O. has had an unexplained weight loss of 5kgs in the last two weeks, his current BMI shows that he has a healthy weight. The evaluation includes urinalysis and blood glucose tests. D.O.’s urinalysis showed positive urine glucose, while the blood glucose test showed elevated blood glucose levels. The random blood glucose test was 250 mg/dL.

Hyperglycemia in type 1 diabetes mellitus is the most likely diagnosis for D.O. He presents with unexplained weight loss, increased urination, irritability, and increased appetite, which are signs and symptoms seen in diabetes mellitus (Syed, 2022). Type 1 diabetes mellitus mostly begins in childhood. D.O. is a ten-year-old, which is an age bracket that falls under childhood. Risk factors of type 1 diabetes mellitus include genetics, where individuals with a first-degree relative suffering from diabetes have an increased risk of suffering from diabetes (Syed, 2022). D.O.’s father, a first-degree relative, is a known diabetic. Also, D.O.’s paternal grandmother, a second-degree relative, is a known diabetic. Due to family history and genetics, D.O. has an increased risk of type 1 diabetes mellitus. A random blood glucose test result of more than 200 mg/dL in a child with classic symptoms of hyperglycemic crisis or hyperglycemia supports a diagnosis of type 1 diabetes mellitus (Syed, 2022). Classical symptoms of hyperglycemia include polyuria, polyphagia, and polydipsia. D.O.’s high random blood glucose of 250 mg/dL plus the classic symptoms of hyperglycemia, which are polyuria and polyphagia, show that D.O. is suffering from hyperglycemia in type 1 diabetes mellitus.

The patient is managed using pharmacological and non-pharmacological therapy. Pharmacological therapy involves the use of insulin therapy to ensure glycemic control. The insulin dose is calculated based on the patient’s current glucose reading. Although D.O. is a 10-year-old child, he must understand the advantages of insulin therapy to ensure compliance. Children need monitoring; therefore, D.O.’s parents are educated on the importance of ensuring that D.O. has his daily insulin therapy. D.O.’s parents are taught how to administer insulin through injections and storage. D.O.’s insulin injections are done daily at a 45-degree angle. D.O.’s parents are educated on how to identify h