Referral letter to Professor of Diabetes Medicine

I should be grateful if you would review this 21-year old woman in your Young Adult Diabetes Clinic. She was diagnosed as having type 1 diabetes mellitus at the age of 10, and was cared for by a paediatrician until moving away to university 3 years ago. She recently graduated and moved to this area with her first job.

She is currently taking human biphasic insulin 30 units in the morning and 15 units in the evening. She says she tries to monitor her blood glucose and to follow her diet, but finds compliance difficult and she has been admitted to hospital with diabetic ketoacidosis six times in the past five years.

She is now planning to get married and has become concerned about the long term consequences of her diabetes, particularly with regard to pregnancy. Routine dipstick urine testing in the surgery showed ++ glucose but was negative for protein and ketones.