Abstract:
:We surveyed the clinical presentation, initial management and subsequent course of a prospectively registered cohort of 60 children with insulin-dependent diabetes mellitus (IDDM) diagnosed before age 15 years in the Sultanate of Oman between January 1990 and December 1993. Clinical details from the time of diagnosis were available on all the children. At diagnosis 9 (15 per cent) presented with severe ketoacidosis (DKA) with pH less than 7.1 or plasma bicarbonate less than 10 mmol/l, and 16 (27 per cent) had mild to moderate ketoacidosis with pH 7.1-7.35 or plasma bicarbonate 10-18 mmol/l. During DKA electrolyte disturbances included: hypokalemia (K < 3.5 mmol/l) 25 per cent), hyperkalemia (K > 5.5 mmol/l) (18 per cent) and hyponatremia (Na < 130 mmol/l) (40 per cent). Serum creatinine concentrations were high in 25 per cent of children with DKA. Within the first year of diagnosis, 17 of the 60 children (28 per cent) experienced symptomatic hypoglycaemia, which in six (10 per cent) led to one or more admissions. Re-admission for unstable glycaemic control, excluding acute hypoglycaemia occurred at least once in six children (10 per cent) within 1 year of diagnosis and in 10 (17 per cent) within 2 years. Statural growth velocity (GV) and GVSDS (6.9 +/- 0.85 cm/year and 0.75, respectively) were significantly higher in the group of children with good glycaemic control (HbA1C = 7.9 +/- 0.4 per cent) compared to those children (3.7 +/- 0.44 cm/ year and -1.6, respectively) with bad glycaemic control (HbA1C = 12.5 +/- 1.5 per cent). Insulin-like growth factor-I (IGF-I) concentrations were significantly higher (260 +/- 21 ng/ml) in the group with good glycemic control v. the group with bad control (149 +/- 15 ng/ml). In summary, greater public and medical awareness of the presenting features of diabetes in young children is needed to reduce the frequency of DKA at presentation, and improvement of patient and family education is necessary to reduce the incidence of DKA and hypoglycaemia in children with IDDM.
journal_name
J Trop Pediatrjournal_title
Journal of tropical pediatricsauthors
Soliman AT,al Salmi I,Asfour Mdoi
10.1093/tropej/43.3.128subject
Has Abstractpub_date
1997-06-01 00:00:00pages
128-32issue
3eissn
0142-6338issn
1465-3664journal_volume
43pub_type
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journal_title:Journal of tropical pediatrics
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journal_title:Journal of tropical pediatrics
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journal_title:Journal of tropical pediatrics
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更新日期:2017-02-01 00:00:00
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journal_title:Journal of tropical pediatrics
pub_type: 杂志文章
doi:10.1093/tropej/41.4.202
更新日期:1995-08-01 00:00:00
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journal_title:Journal of tropical pediatrics
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更新日期:2015-04-01 00:00:00
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journal_title:Journal of tropical pediatrics
pub_type: 杂志文章
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更新日期:1997-10-01 00:00:00
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journal_title:Journal of tropical pediatrics
pub_type: 杂志文章
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更新日期:2020-12-01 00:00:00
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journal_title:Journal of tropical pediatrics
pub_type: 杂志文章
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更新日期:2006-06-01 00:00:00
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journal_title:Journal of tropical pediatrics
pub_type: 杂志文章,随机对照试验
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更新日期:2014-02-01 00:00:00
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journal_title:Journal of tropical pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2005-04-01 00:00:00
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更新日期:2004-02-01 00:00:00
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journal_title:Journal of tropical pediatrics
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更新日期:2011-02-01 00:00:00
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更新日期:2008-08-01 00:00:00
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journal_title:Journal of tropical pediatrics
pub_type: 杂志文章,随机对照试验
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更新日期:2010-02-01 00:00:00
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journal_title:Journal of tropical pediatrics
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更新日期:2000-04-01 00:00:00
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journal_title:Journal of tropical pediatrics
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更新日期:2012-10-01 00:00:00
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journal_title:Journal of tropical pediatrics
pub_type: 杂志文章
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更新日期:1997-08-01 00:00:00
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journal_title:Journal of tropical pediatrics
pub_type: 杂志文章
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更新日期:2010-12-01 00:00:00
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journal_title:Journal of tropical pediatrics
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更新日期:2013-10-01 00:00:00
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更新日期:1989-02-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2000-06-01 00:00:00