ABSTRACT
Diabetes mellitus is a common condition in children, characterised by chronic hyperglycaemia resulting from an absolute insulin deficiency. It can present in various ways, and hospital admission may result from complications related to previously diagnosed diabetes, or from a new diagnosis. To raise awareness of the condition, Diabetes UK has launched the 4Ts campaign, which highlights the four most common symptoms of diabetes. This article discusses the different clinical presentations, diagnosis and management of children with diabetes, and includes two case studies to illustrate some of the challenges faced by emergency department nurses.
Subject(s)
Diabetes Mellitus/diagnosis , Diabetes Mellitus/nursing , Adolescent , Child , Female , Humans , Male , Nursing ProcessABSTRACT
Disturbances in salt and water balances are relatively common in children after brain surgeries for suprasellar and pituitary tumours, presenting diagnostic and therapeutic challenges. Although hypernatraemia associated with central diabetes insipidus is commonly encountered, it is hyponatraemia (HN) that poses more of a diagnostic dilemma. The main differential diagnoses causing HN are the syndrome of inappropriate antidiuretic hormone secretion, marked by inappropriate retention of water, and cerebral salt wasting, characterized by polyuria and natriuresis. Diagnosis and management can be even more difficult when these conditions precede or coexist with each other. These diagnostic and therapeutic dilemmas are discussed in detail in this review.