ABSTRACT
Cerebral edema (CE) is the commonest cause of morbidity and mortality during the first day of treatment for (DKA) in pediatric patients, but if neurological deterioration occurs during treatment of diabetic ketoacidosis, other possibilities must also be considered. We present a 13 month old girl with DKA and meningococcal meningitis.
Subject(s)
Brain Edema/diagnosis , Diabetic Ketoacidosis/complications , Acute Disease , Brain Edema/drug therapy , Brain Edema/etiology , Diabetic Ketoacidosis/physiopathology , Diagnosis, Differential , Female , Humans , InfantABSTRACT
Ninety diabetic children each provided at least one 24-hour blood glucose profile at home using an impregnated filter paper strip. The mean 24-hour blood glucose level correlated significantly with urine control, height velocity, and Hb A1. The correlation coefficient for individual blood glucose values (r = 0.61) and for mean 24-hour blood glucose values (r = 0.73) repeated within 14 days showed an acceptable degree of reproducibility for the blood glucose profiles. Mean 24-hour blood glucose values fell significantly overall (11.4 to 9.8 mmol/l; 205 to 176 mg/100 ml) in 47 children who had repeated profiles more than 2 weeks apart. Unrecognised nocturnal hypoglycaemia (less than 3.0 mmol/l; 54 mg/100 ml) was found in 19% of children on twice-daily Semitard insulin. The study shows that children over age 7 years manage home blood glucose monitoring without difficulty. It shows that the results are reproducible and correlate with other indices of control, and that it provides a practical basis for the improvement of diabetic control.
Subject(s)
Blood Glucose/analysis , Diabetes Mellitus, Type 1/blood , Self Care , Body Height , Child , Diabetes Mellitus, Type 1/drug therapy , Diabetes Mellitus, Type 1/urine , Glycated Hemoglobin/analysis , Glycosuria/urine , Humans , Hypoglycemia/etiology , Insulin/administration & dosageABSTRACT
Height and skeletal maturity scores (TW 2) were determined in 77 diabetic children at diagnosis and again in 48 of them after 1 to 4 years on insulin treatment. Boys, especially those of prepubertal age, were tall at onset. Girls had normal stature, but showed significant growth retardation after treatment. Skeletal maturity was appreciably advanced in both sexes at diagnosis, and on treatment returned to normal only in boys. Girls maintained their advanced skeletal maturity, resulting in an increased disparity between height and skeletal maturity. The results of this study suggest that a prediabetic metabolic abnormality may enhance skeletal maturity in children with diabetes and continues to operate in girls after treatment, despite a reduced growth rate.
