Psychological status of children with type 1 diabetes in Kuwait

Childhood diabetes puts an enormous burden on both the child and his family and may put them at increased risk for psychological problems. The purpose of the study was to assess the psychological reactions to type 1 diabetes in children and the effect of glycemic control on them. A specially designed questionnaire was used to collect demographic data. The children behavioral check list and the Arabic childhood depression inventory were used to assess depression, anxiety and other behavioral disorders. Social workers and research assistants interviewed the patients in the outpatients of the 5 hospitals. Controls were interviewed at school. A total of 215 diabetic and 221 age and sex matched healthy subjects were enrolled in the study. Measure depression, and other behavioral disorders in diabetic patients. Mild depression was reported in 63% of the diabetic subjects, 3-fold higher than in the control group [p < 0.05]. Medium and high anxiety scores were significantly more frequent in diabetic children [p <0.001, and p < 0.01 respectively] Attention, concentration problems, hyperactivity and aggressive behavior were significantly more frequent in the diabetic children compared to matched controls. There was a significant association between poor glycemic control and depression; p < 0.001. hyperactivity [p = 0.001], poor attention [p - 0.007], and aggression [p = 0.03]. Children with diabetes are at increased risk of depression and behavioral problems. Regular psychological assessment along with medical treatment must be addressed to optimize control

Successful transfer from insulin to oral sulfonylurea in a 3-year-old girl with a mutation in the KCNJ11 gene

Neonatal diabetes mellitus is considered a rare disease that is diagnosed in the first six months of life, and can be either transient or permanent. Recent advances in molecular genetics have shown that activating mutations in KCNJ11 [the gene that encodes for the Kir6.2 subunit of the K[ATP] potassium channel of the pancreatic beta-cell] is a common cause of permanent neonatal diabetes mellitus. Patients with mutations in this gene may respond to oral sulfonyureas. We describe a 3-year-old girl with permanent neonatal diabetes mellitus with a mutation in the KCNJ11 gene [R201H], who was successfully transferred from subcutaneous insulin to oral glibenclamide, with a marked improvement in glycemic control. This is the first successful switch from insulin to oral sulfonylurea in a patient with R201H mutation, in the Arabian Gulf