Type 1 diabetes new diagnosis — MCCQE Part 1 MCQ

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EasyPaediatricsType 1 diabetes new diagnosisMCCQE Part 1

A 12-year-old has polyuria, polydipsia, weight loss, random glucose 18 mmol/L and ketones, but normal pH and hydration. Which of the following is the most appropriate next step?

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Correct answer: E — Arrange same-day paediatric diabetes assessment and start insulin education and therapy

Arrange same-day paediatric diabetes assessment and start insulin education and therapy is the single best answer because the age, timing, examination findings and investigations in the vignette fit Type 1 diabetes new diagnosis better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Diabetes Canada CPG, with attention to acuity, safety-netting and local provincial pathways.

Reference: Diabetes Canada CPG