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Transient incidental glucosuria in children
Insights
Transient asymptomatic glucosuria in children can predict insulin-dependent diabetes mellitus. Early detection of islet cell antibodies and impaired insulin response may guide preventative therapies.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Disorders
Background:
- Transient asymptomatic glucosuria is a condition observed in children.
- The long-term implications and predictive value of this finding require further investigation.
Purpose of the Study:
- To investigate the long-term outcomes of children diagnosed with transient asymptomatic glucosuria.
- To identify risk factors associated with the development of insulin-dependent diabetes mellitus in this cohort.
Main Methods:
- A cohort of 78 children with transient asymptomatic glucosuria was prospectively followed for up to 7.3 years.
- Patients were assessed for blood glucose levels, islet cell antibodies, and first-phase insulin response.
Main Results:
- Five patients (6.4%) developed insulin-dependent diabetes mellitus within 2.1 years.
- These patients exhibited higher blood glucose levels and, in three cases, positive islet cell antibodies with subnormal first-phase insulin response.
- Among the remaining children, islet cell antibodies were found in 3, and 12/55 had impaired first-phase insulin response, with some showing deterioration and others normalization.
Conclusions:
- Transient glucosuria in children, especially when accompanied by islet cell antibodies and a subnormal first-phase insulin response, indicates a risk for developing insulin-dependent diabetes mellitus.
- Consideration of therapeutic interventions in high-risk children is warranted to prevent overt diabetes.
Abstract:
A consecutive series of 78 children with transient asymptomatic glucosuria was studied and followed up for up to 7.3 years. The age at presentation was 0.9-17.6 (median 4.6) years. One third of the patients had random blood glucose levels of > 10.0 mmol/l (180 mg/dl). Five patients (6.4%) developed insulin-dependent diabetes mellitus within 2.1 years after the first incident of glucosuria. These patients presented with higher levels of glycaemia than others, and three out of five were positive for islet cell antibodies with a first-phase insulin response < 46 mU/l in all four studied. Of the remaining 73 children, 3 were positive for islet cell antibodies and 12/55 had a first-phase insulin response under 46 mU/l. The insulin response deteriorated in 3 but reverted to normal in 7 patients. CONCLUSION. For a child with transient glucosuria and with presence of islet cell antibodies and a subnormal first-phase insulin response, therapeutic attempts to prevent overt insulin-dependent diabetes mellitus should be considered.