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Insulin dependent diabetes in children.

G Jain1, G Patel, M J Mehta

  • 1Department of Pediatrics, B.J. Medical College and Civil Hospital, Ahmedabad.

Indian Journal of Pediatrics
|September 1, 1991
PubMed
Summary

This study reviews twenty children with insulin-dependent diabetes mellitus, highlighting that most presented with diabetic ketoacidosis. Poor glycemic control was observed in over half of the followed patients.

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Area of Science:

  • Pediatrics
  • Endocrinology
  • Metabolic Disorders

Background:

  • Insulin-dependent diabetes mellitus (IDDM) is a chronic condition requiring lifelong management.
  • Diabetic ketoacidosis (DKA) is a serious complication of IDDM, particularly in children.
  • Understanding the presentation and outcomes of pediatric DKA is crucial for improving patient care.

Purpose of the Study:

  • To describe the clinical experience with pediatric patients admitted for insulin-dependent diabetes mellitus.
  • To evaluate the initial presentation, treatment, and short-term outcomes of these patients.
  • To assess glycemic control and complication rates in a cohort of children with IDDM.

Main Methods:

  • Retrospective review of twenty pediatric patients with IDDM admitted over 2.5 years.
  • Analysis of patient demographics, clinical presentation (acute vs. gradual onset), and treatment received.
  • Assessment of glycemic control using glycosylated hemoglobin (HbA1c) levels and documentation of complications like DKA and hypoglycemia during follow-up.

Main Results:

  • Sixteen of twenty children presented with acute onset diabetic ketoacidosis (DKA).
  • One patient died during the acute phase.
  • Among eleven patients followed for 3-6 months, only three showed good glycemic control (HbA1c), while six had poor control. Six patients experienced recurrent DKA, and three had hypoglycemia.

Conclusions:

  • Pediatric patients with insulin-dependent diabetes mellitus frequently present with severe diabetic ketoacidosis.
  • Achieving and maintaining adequate glycemic control remains a significant challenge in this population.
  • Close monitoring and proactive management are essential to prevent recurrent DKA and hypoglycemia in children with IDDM.

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