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Childhood Insulin-Dependent Diabetes mellitus: Initial Presentation and Management in the Nineties

Childhood Insulin-Dependent Diabetes mellitus: Initial Presentation and Management in the Nineties Diabetes mellitus with onset during childhood usually presents as overt ketoacidemia. Pediatricians now inquire specifically about diabetes mellitus in children with nonspecific signs of illness and perform urinary dipstick testing. The present study was therefore performed to assess the possible influence of this strategy on the initial presentation and management of diabetes mellitus. The charts of 61 consecutive children with newly diagnosed diabetes mellitus (positive glucosuria and ketonuria and capillary glucose >14 mmol/l), who had been admitted between 1991 and 1996 at the Department of Pediatrics, University of Bern, Switzerland, were therefore reviewed. Twenty-six out of the 61 patients were nonacidemic (blood pH 7.36 or more). Children with and without acidemia did not differ with respect to age, history of polydipsia and polyuria, plasma glucose and circulating glycated hemoglobin A<sub>1c</sub>. The degree of dehydration and the amount of fluid required for its correction and the total insulin dosage were more prominent in the group of patients with acidemia. The study demonstrates that childhood diabetes mellitus is nowadays often recognized as nonacidemic hyperglycemia and that in these patients a reduced initial fluid repair and total insulin dosage is recommended. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Mineral and Electrolyte Metabolism Karger

Childhood Insulin-Dependent Diabetes mellitus: Initial Presentation and Management in the Nineties

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Publisher
Karger
Copyright
© 1998 S. Karger AG, Basel
ISSN
0378-0392
eISSN
1423-016X
DOI
10.1159/000057391
Publisher site
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Abstract

Diabetes mellitus with onset during childhood usually presents as overt ketoacidemia. Pediatricians now inquire specifically about diabetes mellitus in children with nonspecific signs of illness and perform urinary dipstick testing. The present study was therefore performed to assess the possible influence of this strategy on the initial presentation and management of diabetes mellitus. The charts of 61 consecutive children with newly diagnosed diabetes mellitus (positive glucosuria and ketonuria and capillary glucose >14 mmol/l), who had been admitted between 1991 and 1996 at the Department of Pediatrics, University of Bern, Switzerland, were therefore reviewed. Twenty-six out of the 61 patients were nonacidemic (blood pH 7.36 or more). Children with and without acidemia did not differ with respect to age, history of polydipsia and polyuria, plasma glucose and circulating glycated hemoglobin A<sub>1c</sub>. The degree of dehydration and the amount of fluid required for its correction and the total insulin dosage were more prominent in the group of patients with acidemia. The study demonstrates that childhood diabetes mellitus is nowadays often recognized as nonacidemic hyperglycemia and that in these patients a reduced initial fluid repair and total insulin dosage is recommended.

Journal

Mineral and Electrolyte Metabolism – Karger

Published: Oct 1, 1998

Keywords: Acidosis; Dehydration; Diabetes mellitus, insulin-dependent; Fluid therapy; Insulin

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