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Hyperphosphaturia and hypermagnesuria in children with IDDM
S W Ponder1, B H Brouhard, L B Travis
1Department of Pediatrics, Cleveland Clinic Foundation, Ohio.
Diabetes Care
|April 1, 1990
Summary
Children with insulin-dependent diabetes mellitus (IDDM) excrete more phosphorus and magnesium in their urine, especially with high glucose levels. This may increase their risk for mineral deficiencies without careful insulin management.
Area of Science:
- Pediatric Endocrinology
- Diabetic Nephropathy
- Mineral Metabolism
Background:
- Insulin-dependent diabetes mellitus (IDDM) is a chronic condition affecting children.
- Altered mineral excretion is a potential complication of diabetes.
- Understanding urinary mineral loss is crucial for managing long-term health in diabetic children.
Purpose of the Study:
- To investigate urinary excretion of calcium, phosphorus, and magnesium in children with IDDM.
- To determine the relationship between urinary mineral excretion and glycemic control.
- To assess the risk of mineral deficiencies in pediatric IDDM.
Main Methods:
- Collected spot urine samples from 220 children with IDDM and 33 healthy controls.
- Measured urinary calcium-creatinine (UCa/Cr), magnesium-creatinine (UMg/Cr), and phosphorus-creatinine (UP/Cr) ratios.
- Correlated mineral excretion with urine glucose, age, diabetes duration, HbA1c, and insulin dosage.
Main Results:
- Elevated UMg/Cr and UP/Cr in IDDM children compared to controls (P=0.0001).
- UCa/Cr, UMg/Cr, and UP/Cr correlated with urine glucose levels.
- Increased phosphorus and magnesium loss occurred even with good glycemic control.
- Urinary calcium loss increased significantly during periods of glucosuria.
Conclusions:
- Children with IDDM exhibit elevated urinary phosphorus and magnesium excretion, independent of glycemic control.
- Glucosuria exacerbates urinary mineral losses, particularly for calcium.
- These findings suggest a potential risk for mineral deficiencies in pediatric IDDM without intensive management.