Endocrine Abstracts

Type 1 diabetes mellitus is a common autoimmune condition affecting both humans and canines. Traditionally, the condition is diagnosed upon presentation to hospital with diabetic ketoacidosis (DKA). Continuous glucose monitoring (CGM) is now the standard of care for all individuals with type 1 diabetes mellitus, including the canine population. A 19-year-old female presented to the emergency department with hyperglycaemia while wearing a CGM device. She had developed symptoms similar to her dog, who is also being treated for diabetes mellitus and wears a CGM monitor. On arrival, her blood glucose was 21.9 mmol/l, ketones 4.1 mmol/l, pH 7.36, and bicarbonate 21.5 mmol/l. HbA1c was 105 mmol/mol, consistent with the hyperglycaemic trends seen on her CGM device. She was treated with intravenous fluids and subcutaneous insulin, as she did not meet the criteria for DKA. She was discharged within 8 hours to a virtual ward, where she continued to be monitored via CGM. Subsequent antibody testing confirmed a diagnosis of type 1 diabetes mellitus. With the increasing use of CGM devices, glucose data is now often available at the time of diagnosis of diabetes mellitus, prior to the development of DKA. Sensor technology is also expanding to include non-invasive glucose monitoring methods, such as infrared spectroscopy. As a result, CGM data may become available for a growing number of individuals without a diagnosis of diabetes mellitus. This could potentially reduce the number of people presenting to hospital in DKA and transform the early experience of living with type 1 diabetes mellitus.