Type 1 diabetes

​​​​​​​Emergency

If any of the following are suspected, seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary)

  • Concerns of ketoacidosis with known type 1 diabetes and any of the following symptoms or results:
    • > 2 vomiting episodes
    • Abdominal pain
    • Altered conscious state
    • Headache
    • Inability to eat (even if not vomiting)
    • Ketones; blood > 1.5 mmol, urine moderate or large
    • Shortness of breath
    • Systemic symptoms (i.e. fever, lethargy)
  • Known type 1 diabetes with any of the following features:
    • Persistent vomiting with hypoglycaemia or hyperglycaemia or inability to tolerate oral fluids
    • Severe hypoglycaemia (i.e. coma, convulsions, altered consciousness)
  • New diagnosis or suspicion of type 1 diabetes as indicated by any of the following symptoms or results:
    • HbA1c > 6.5%
    • Oral glucose tolerance test (OGTT) with fasting blood glucose level > 7.0 mmol/L and/or 2 hours
       > 11.1 mmol/L
    • Polyuria and/or polydipsia
    • Random blood glucose level > 11.0 mmol/L

When public outpatient services are not routinely provided

  • ​​​Nil

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Aged < 5 years with known type 1 diabetes
    Note: only exception is where there has been previous assessment by a diabetologist within the last 2 months
  • Type 1 diabetes and other significant medical
    co-morbidities (e.g. eating disorders)
  • Type 1 diabetes who is at increased risk due to psychosocial factors, including but not limited to:
    • Currently in out-of-home care
    • Disability
    • Language barriers affecting diabetes management
    • Refugee status​
​Category 2
Recommended to be seen within 90 calendar days.

​
  • Aged > 5 years with stable type 1 diabetes
  • Stable, known diabetes transferring care seen by an endocrinologist within the last 2 months or a general paediatrician within the last 3 months​

Category 3
Recommended to be seen within 365 calendar days.

  • ​Nil

Information to include within a referral

Required

  • Reason for referral
  • Details of the presenting condition, including symptoms and their duration
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • Height, weight
    • Presence of concerning features (e.g. recent weight loss)
    • Relevant investigations performed in the past 12 months
      • HbA1c
      • Full blood count (FBC)
      • Liver function test (LFT)
      • Thyroid function test (TFT)
      • Coeliac screen and IgA
      • Lipids (total cholesterol, LDL, HDL, triglycerides)
      • Urea, Electrolytes, Creatinine (UEC)
      • Urine albumin-to-creatinine ratio (ACR)

Note: if referring for positive diabetes antibodies, discussion with a paediatric endocrinologist may be indicated to determine clinical urgency​

If available

  • Mode of presentation (i.e. insidious or acute)
  • Other past medical history
  • Family history, including diabetes, polycystic ovary syndrome and other endocrine conditions
  • Head circumstance and growth charts with prior measurements
  • Birth history
  • Significant psychosocial risk factors
  • Other physical examination findings
  • Any other relevant laboratory tests or medical imaging​

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.​​

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing