Patient Age, Race and the Type of Diabetes Have an Impact on the Presenting Symptoms, Latency Before Diagnosis and Laboratory Abnormalities at Time of Diagnosis of Diabetes Mellitus in Children - Original Article

摘要

Objective:To correlate the presence and duration of the symptoms with laboratory data in children with new onset diabetes mellitus (DM) and to determine the impact of gender, race, age, and type of diabetes on these relationships.Methods:This was a single institution prospective study in which we asked the families of 112 children with new-onset DM a standard set of questions concerning the presence and duration of symptoms. We then reviewed selected laboratory data and explored the relationships between the symptoms, laboratory findings, gender, age, race, type of diabetes (T1DM or T2DM), and presence or absence of a history of diabetes in a close relative.Results:Over 90% of patients had polyuria and polydipsia (mean duration 17 and 19 days), but only 50% of the families sought medical attention for this complaint. Children less than 5 years of age and African American children with T1DM were more dehydrated at presentation. More profound acidosis was seen in patients of younger age (<5 years), those with greater weight loss (9% or higher), and those with higher initial serum glucose (p<0.01). Mean hemoglobin A1c (HbA1c) was close to 11% for each subgroup and strongly correlated with the proportion of weight loss (p=0.0015), but not with the initial blood glucose, corrected serum sodium, or BUN levels.Conclusions:Parents of children with new onset DM might not report polyuria or polydypsia as their main concern when they seek medical attention, so primary care physicians must be alert to the diagnosis of diabetes in any child with significant weight loss. Young children (<5 years old) and African American children with new onset T1DM are more dehydrated and young children (<5 years old) are more acidotic.