Once a year they do a full blood test for liver function, coeliac etc. As my daughter is young (I assume that is the reason) they've never done a cholesterol test. Why is it necessary to do these tests every year on young children? If she develops coeliac disease there will be symptoms which would flag up a problem, so why is screening necessary? What is the liver function test for, why is it so important for a diabetic to have this test done? I can't remember what else they test for. If the patient has good control, is a child and has had diabetes for less than 10 years why do we need to test every year for something that is unlikely to go wrong until later in life? Eye tests have never been done even although I've asked about it (they only start from 12 or 14 years old I can't remember which age it was now), surely if anything is going to show up first it would be retinopathy? I've taken Jess along to the optitians myself to have eye tests done as I feel that is more important than any of the other tests right now. Kidney function test has also now been done on my request but wouldn't have been done yet had I not asked.
Yearly blood tests, annual review
- Thread starter SophiaW
- Start Date
Hi Sophia,
One of the most important thing they check is HBa1c. They will do a load of other checks too, kidney, liver, usually cholesterol. To be honest I've never really understood why they check all the things they do. With regards to kidney function, this is an important one. The blood test can show up kidney problems when they are still in very, very early stages. Diabetes are at much at risk of this as they are of retinopathy. Of course, if your daughter has good control they she will, hopefully, not be affected. With regards to coeliacs, some of the symptoms can be incredibly vague and, therefore, hard to diagnose. I felt unwell (bloated, tired etc) for ages before a blood test finally showed that I might have coeliacs. Before this the doctors just kept telling mr it was IBS or I wasn't eating the right things etc.
I know the blood tests aren't nice for kids at all - I was very young when I was diagnosed and remember them well. I hated needle, still do actually! The DSN used to give my mam a sachet of numbing cream that I would apply before going to have blood taken. This was a long time ago, but might be worth asking if they could give you something similar.
Emma
One of the most important thing they check is HBa1c. They will do a load of other checks too, kidney, liver, usually cholesterol. To be honest I've never really understood why they check all the things they do. With regards to kidney function, this is an important one. The blood test can show up kidney problems when they are still in very, very early stages. Diabetes are at much at risk of this as they are of retinopathy. Of course, if your daughter has good control they she will, hopefully, not be affected. With regards to coeliacs, some of the symptoms can be incredibly vague and, therefore, hard to diagnose. I felt unwell (bloated, tired etc) for ages before a blood test finally showed that I might have coeliacs. Before this the doctors just kept telling mr it was IBS or I wasn't eating the right things etc.
I know the blood tests aren't nice for kids at all - I was very young when I was diagnosed and remember them well. I hated needle, still do actually! The DSN used to give my mam a sachet of numbing cream that I would apply before going to have blood taken. This was a long time ago, but might be worth asking if they could give you something similar.
Emma
phoenix
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The NICE guidelines have been altered for coeliac
Children and young people with type 1 diabetes should be
offered screening for:
• coeliac disease at diagnosis
and at least every 3 years thereafter until transfer to
adult services this has been crossed out in the guideline... the crossing out hasn't survived the cut and paste.
• thyroid disease at diagnosis and annually thereafter
until transfer to adult services
• retinopathy annually from the age of 12 years
• microalbuminuria annually from the age of 12 years
• blood pressure annualy from the age of 12 years.
1.3.5.2 Routine screening for elevated blood lipid levels and/or
neurological function is not recommended for children
and young people with type 1 diabetes.
Children and young people with type 1 diabetes should
be offered:
• annual foot care reviews
• investigation of the state of injection sites at each
clinic visit.
1.3.5.4 Children and young people with type 1 diabetes and their
families should be informed that, as for other children,
regular dental examinations
*
and eye examinations
(every 2 years) are recommended. (thats normal eye checks not retinal)
p221 ff of this document lists the evidence that they use to come to these recommendations. (it is just a list of studies and the brief findings of each)
http://www.nice.org.uk/nicemedia/live/1 ... /29395.pdf
Its interesting though that the 3 yearly coeliac testing requirement has been removed (know indication why) There is no mention of liver function tests
Children and young people with type 1 diabetes should be
offered screening for:
• coeliac disease at diagnosis
and at least every 3 years thereafter until transfer to
adult services this has been crossed out in the guideline... the crossing out hasn't survived the cut and paste.
• thyroid disease at diagnosis and annually thereafter
until transfer to adult services
• retinopathy annually from the age of 12 years
• microalbuminuria annually from the age of 12 years
• blood pressure annualy from the age of 12 years.
1.3.5.2 Routine screening for elevated blood lipid levels and/or
neurological function is not recommended for children
and young people with type 1 diabetes.
Children and young people with type 1 diabetes should
be offered:
• annual foot care reviews
• investigation of the state of injection sites at each
clinic visit.
1.3.5.4 Children and young people with type 1 diabetes and their
families should be informed that, as for other children,
regular dental examinations
*
and eye examinations
(every 2 years) are recommended. (thats normal eye checks not retinal)
p221 ff of this document lists the evidence that they use to come to these recommendations. (it is just a list of studies and the brief findings of each)
http://www.nice.org.uk/nicemedia/live/1 ... /29395.pdf
Its interesting though that the 3 yearly coeliac testing requirement has been removed (know indication why) There is no mention of liver function tests
Yep, she doesn't like the blood tests and I can fully understand that. They often struggle to get the needle in the vein or get enough blood out in one go, it's very distressing for Jess. We have used the Emla cream but Jess has a reaction to it making it worse, the site becomes inflamed and red within minutes.
The HbA1c test is done every clinic visit, which currently is every 4 months, and that is done by doing a finger prick so not necessary for the HbA1c to be done at the annual blood test. They don't check cholesterol at this age. The kidney test as far as I'm aware is the urine test which I requested so that's not included in the annual blood test. I agree the kidney test is an important one to have done and which is why I asked for it to be done. She also has blood pressure, weigh and height done. Never been offered any sort of foot care advice or screening. Dentist we see every 6 months and as already mentioned I take her to the optician every year, they do the photograph of the retina during the eye check.
As far as I recall the only tests specifically at this annual blood test is liver function (I'm unsure about this one, I might be confusing it with a blood test I had done recently for myself, perhaps liver function isn't on Jess' test), thyroid and coeliac. My reasoning is that if she developed thyroid or coeliac problems then they would present with symptoms and I would then see the importance of a blood test to diagnose once the symptoms have presented themselves. Our non-diabetic children are not subjected to annual blood tests "just incase" so why must diabetic children have them when there's a chance she may never develop these problems. And if she does develop the problem then can't it be diagnosed just like any other child without diabetes would be diagnosed i.e. on presenting with symptoms?
Does anyone know what the increased likelihood of developing coeliac or thyroid problems is for a type 1 diabetic child as opposed to a non-diabetic child?
The HbA1c test is done every clinic visit, which currently is every 4 months, and that is done by doing a finger prick so not necessary for the HbA1c to be done at the annual blood test. They don't check cholesterol at this age. The kidney test as far as I'm aware is the urine test which I requested so that's not included in the annual blood test. I agree the kidney test is an important one to have done and which is why I asked for it to be done. She also has blood pressure, weigh and height done. Never been offered any sort of foot care advice or screening. Dentist we see every 6 months and as already mentioned I take her to the optician every year, they do the photograph of the retina during the eye check.
As far as I recall the only tests specifically at this annual blood test is liver function (I'm unsure about this one, I might be confusing it with a blood test I had done recently for myself, perhaps liver function isn't on Jess' test), thyroid and coeliac. My reasoning is that if she developed thyroid or coeliac problems then they would present with symptoms and I would then see the importance of a blood test to diagnose once the symptoms have presented themselves. Our non-diabetic children are not subjected to annual blood tests "just incase" so why must diabetic children have them when there's a chance she may never develop these problems. And if she does develop the problem then can't it be diagnosed just like any other child without diabetes would be diagnosed i.e. on presenting with symptoms?
Does anyone know what the increased likelihood of developing coeliac or thyroid problems is for a type 1 diabetic child as opposed to a non-diabetic child?
