RESUMO
Introduction: Le diabete de type 1 (DT1) est l'une des endocrinopathies les plus frequentes chez l'enfant. L'objectif de cette etude etait de decrire les aspects epidemiologiques; cliniques et evolutifs du DT1 au Centre Hospitalier National d'Enfants Albert Royer.Patients et methodes: Il s'agissait d'une etude retrospective descriptive incluant tous les enfants ages de 0 a 15 ans hospitalises dans le service pour DT1 de 2007 a 2013. Nous avons analyse les donnees socio-demographiques; cliniques et evolutives. Resultats: Cent dix neuf (119) enfants etaient admis durant cette periode; representant une prevalence hospitaliere de 3;6 %. L'age moyen etait de 7;8 ans et le sex ratio 1;2 en faveur des garcons. L'origine etait suburbaine dans 65;9%. Le niveau socio-economique et le niveau d'education des parents etaient juges bas dans 65;9% et 63;6% respectivement. Un antecedent familial de diabete etait retrouve pour 77;3% des patients. L'acidocetose etait la circonstance de decouverte la plus frequente (86% des cas). La letalite hospitaliere etait de 6;7%. Seuls 24 patients (20;16 %) etaient regulierement suivis dans le service et 49 (41;17%) patients avaient interrompu leur suivi. Conclusion: L'augmentation croissante de la prevalence est une preoccupation de sante publique avec une implication socio-economique. Des efforts doivent etre faits pour un diagnostic precoce et un suivi de qualite. Ceci passe par la formation et le renforcement des capacites des prestataires de sante au niveau peripherique et une meilleure collaboration des differents services de prise en charge du diabete de l'enfant
Assuntos
Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/epidemiologia , Cetoacidose Diabética , Progressão da DoençaRESUMO
Background: Studies in most countries have shown an increasing incidence of diabetes mellitus in children and young adults. Double diabetes is a newly recognized problem in children with different diagnostic and therapeutic measures. Methods: A review of over 30 literature obtained from Google; PUBMED search and journal publications on ""double diabetes"" was done to determine the incidence; pathophysiology; pathogenesis; diagnostic criteria; treatment and prevention of double diabetes in children and young adults. Results: Most of the reports on double diabetes were from western countries and Asia. Type 1 diabetes resulting from antibodies to the insulin-producing pancreatic beta cell was more prevalent in children. However; with increasing obesity the incidence of type 2 diabetes resulting from insulin resistance was high in children and young adults. Most patients with double diabetes were established type 1 diabetics; who while on insulin and on hypercaloric diet developed obesity especially during puberty and hence associated type 2 diabetes. The incidence was more in black than in white children. They presented with some clinical and laboratory features of both types 1 and 2 diabetes. Some authors advocated treatment with both insulin and oral hypoglycaemic drugs mainly metformin to improve insulin sensitivity. Prevention of childhood obesity by encouraging physical activities and dietary control would prevent double diabetes. Conclusion: Double diabetes is increasing in children and young adults. A high index of suspicion is required in obese children with diabetes