Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
Chapter 139. The Child with Diabetes
Sections: Epidemiology, Pathophysiology, Clinical Features, Treatment, Disposition and Follow-Up, Hyperglycemia without Ketoacidosis, Acknowledgments, References.
Topics Discussed: diabetes mellitus; diabetes mellitus, type 1; diabetic ketoacidosis.
Excerpt:"Diabetes is subclassified into several different forms. Type
1 diabetes, previously referred to as juvenile-onset diabetes because
of its earlier onset, is characterized by an abrupt and frequently
complete decline in insulin production. Type 2 diabetes, previously
referred to as adult-onset diabetes, is marked
by increasing insulin resistance and is most commonly found in obese
adults. Type 2 diabetes now occurs in overweight adolescents with
a strong genetic tendency toward the disease. Type 1 diabetes (no
longer called insulin-deficient diabetes mellitus)
is the most common pediatric endocrine disorder, with an estimated
prevalence of 1 in 400. As many as 27% to 40% of
children with new-onset type 1 diabetes present in diabetic ketoacidosis (DKA).1 In
children with known diabetes, DKA is much less common and tends
to be clustered in a small subset of patients, with 5% of
children with diabetes accounting for nearly 60% of DKA
episodes.2 DKA is the leading cause of mortality
in patients with diabetes <24 years of age, and cerebral edema
is the leading cause of mortality in DKA.3..."
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