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[Insulin-dependent diabetes mellitus. Study and follow-up of 100 cases]
Insights
This study analyzed 100 pediatric patients with insulin-dependent diabetes mellitus (IDDM), tracking their health over 6.1 years. Findings show a decrease in initial symptom severity and highlight the importance of monitoring for complications in pediatric diabetes management.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Diabetes Research
Background:
- Insulin-dependent diabetes mellitus (IDDM) is a chronic condition requiring long-term management in children.
- Understanding the progression and complications of pediatric IDDM is crucial for effective treatment strategies.
Purpose of the Study:
- To analyze the clinical course and outcomes of 100 pediatric patients with IDDM.
- To evaluate the development of microvascular complications and neuropathy over an extended follow-up period.
Main Methods:
- Longitudinal analysis of clinical records from 100 pediatric IDDM patients.
- Regular monitoring of weight, height, blood pressure, HbA1c, C-peptide, triglycerides, and renal function.
- Fluorescein angiography for microvascular abnormalities and nerve conduction studies for neuropathy.
Main Results:
- Initial symptoms at onset included hyperglycemia, ketoacidosis (14%), or coma (11%), with decreasing severity over time.
- Islet cell antibodies were present in 83% of cases at diagnosis.
- 17% experienced ketoacidosis post-diagnosis, often linked to infection or emotional issues.
Conclusions:
- Pediatric IDDM patients show a trend towards reduced initial symptom severity over years of follow-up.
- Early detection and management of complications like ketoacidosis are vital.
- Family history and autoimmune markers (islet cell antibodies) are relevant factors in pediatric IDDM.
Unlabelled:
Clinical records of one hundred pediatric patients affected by IDDM have been analyzed. All the patients have been followed since the beginning of the disease and they have had a check up on average of four months (weight, height, blood pressure, HbA1, C peptide, Triglyceridemia, renal function were evaluated). The method of home-self-monitoring was applied. After four years, and periodically thereafter, microvascular abnormalities were evaluated in all the patients by fluorescein angiography. Neuropathy was evaluated only in symptomatic patients by peripheral nerve conduction. The average follow up period was 6.1 years (range 1-20).
Results:
the onset of the disease was expressed in 11% of the cases by coma, in 14% by ketoacidosis, in the remaining cases by hyperglycemia only. The severity of initial symptoms has progressively and significantly decreased in the last years. In 7% of the subjects diabetes affected more members of the same family (4 couples of siblings and 3 couples of parent-child). An infection preceding the onset of the disease was present in the history of 23% of the cases. Islet cell antibodies were found in 83% of the studied cases at the onset of the disease. In 80 out of the 100 patients a detailed history has been obtained about the occurrence of ketoacidosis episodes after the first admission and about the occurrence of severe hypoglycemic crises (seizures and/or coma). 17% of the patients presented at least one ketoacidosis episode after the first admission (the main cause was infection before 12 years of age, an emotional problem thereafter).(ABSTRACT TRUNCATED AT 250 WORDS)