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Professor Bowden writes a mostly excellent editorial. I learned from it.
But some of his advice is inappropriate for NHS primary care. I quote
"Questions about polyuria and enuresis should always be part of the review
of systems during history taking in visits to primary care. Dipstick
testing of urine for glucose and ketones should be done routinely in any
sick child, especially those under 6 years, whether or not the cause of
sickness is known."
We NHS GPs don't really do a systems review most times and I doubt if
senior NHS consultants do either. As for routine urine dipsticks, how on
earth can we educate parents in appropriate management of childhood minor
illness (ie, don't rush to the GP every time) if we insist on a urine
sample for every cold, cough and sore throat? Picking up Diabetes early is
a laudable aim but the NHS GP service will grind to a halt if we
medicalise every minor childhood symptom brought to us.