When should I consider referring a patient with Type 1 Diabetes to a specialist for further management?

You should consider referring a patient with Type 1 Diabetes to a specialist for further management in several key situations, depending on their age and clinical needs:

• For children and young people (aged 12 months to 17 years) with suspected Type 1 Diabetes, an immediate (same-day) referral to a multidisciplinary paediatric diabetes team is required to confirm diagnosis and provide immediate care ². This team will also provide an ongoing integrated package of care ⁴.
• For adults (aged 18 years and onwards) with a new diagnosis of Type 1 Diabetes, the diabetes specialist team should develop and explain a plan for their early care ³. An individual care plan should be set up by the diabetes specialist team, with arrangements for implementation and a review in the following weeks ³.
• For ongoing management across all ages, patients with Type 1 Diabetes require an ongoing integrated package of care provided by a multidisciplinary diabetes team ³,⁴. This includes regular contact with the diabetes team, such as attending clinic four times a year for young people, to help maintain optimal blood glucose levels ²,⁴.
• For specific advanced treatments or complex issues, specialist referral is necessary. This includes considering referral for islet or pancreas transplantation ¹. Additionally, the specialist team manages advanced therapies such as continuous subcutaneous insulin infusion (insulin pump) therapy or hybrid closed-loop systems ¹. If an adult patient has erratic and unpredictable blood glucose control (hyperglycaemia and hypoglycaemia at no consistent times), the specialist team will assess factors like injection technique, self-monitoring skills, and mental health before changing an optimised insulin regimen ¹.