A 15 year-old girl with insulin dependent diabetes mellitus of 11 years duration developed severe neuropathy involving the bladder and stomach. The bladder recovered after 2 months of intermittent catheterization. Metoclopramide relieved the gastric symptoms. Gastric emptying was normal after 2 further months of treatment. The neuropathy developed in spite of a mean HbA1c of 7.4% suggesting that factors in addition to glycemic control play a role in the development of the complications of insulin dependent diabetes mellitus.

Adolescent↗

PubMedDate not supplied

Bone mass in children with congenital hypothyroidism treated with thyroxine since birth.

To determine whether the large doses of thyroxine treatment early in life adversely affect bone mass, we measured bone mass of 20 congenital hypothyroid (CH) patients (8.4 +/- 2.2 years) who were diagnosed and treated since birth. Starting thyroxine dose and current dose were 8.5 +/- 1.9 micrograms/kg/day and 3.1 + 1.2 micrograms/kg/day respectively. Thyroid function and serum biochemical tests for calcium homeostasis were normal at the time of study. Bone mass was measured by dual energy X-ray absorptiometry. Nine siblings served as controls. The patients' bone mineral density was within the normal range of population controls, and was not different from the sibling controls. The patients also had height-adjusted bone mineral content equal to the expected height-adjusted values in the siblings. Our studies indicate that the large doses of thyroxine therapy for CH do not cause osteopenia in childhood.

Absorptiometry, Photon↗

PubMedDate not supplied

Residual beta-cell function in children with IDDM: reproducibility of testing and factors influencing insulin secretory reserve.

Reproducibility of C-peptide secretion was assessed in 20 children (group 1) by their responses to two Sustacal- (a mixed liquid meal) stimulation tests performed 7-14 days apart. For the 12 C-peptide-positive children (basal C-peptide greater than or equal to 0.03 pmol/ml) there were no differences in the basal or stimulated values between tests 1 and 2. The effect of exogenous insulin on C-peptide secretion was assessed in 20 other children (group 2) by their responses to two Sustacal tests, one test without and one with soluble insulin (0.25 U/kg) injected subcutaneously before testing. Eleven children were C-peptide positive and had no differences in C-peptide response between tests 1 and 2. The results from test 1 in groups 1 and 2 were combined with those from 44 others undergoing a single Sustacal test (group 3, N = 84). There was a close correlation between basal and peak C-peptide concentrations in the 44 C-peptide-positive children (r = .88, P less than .001). Peak C-peptide concentrations correlated inversely with HbA1 (r = -.29, P less than .01), insulin dose in units per kilogram (r = -.40, P less than .001), and duration of diabetes (r = .33, P less than .001) and positively with age at onset of diabetes (r = .34, P less than .001). The C-peptide-positive children had reduced glucose response to Sustacal, lower HbA1 concentration, lower insulin requirement, later age of onset, and shorter duration of diabetes than children who were C-peptide negative.

Adolescent↗

PubMedDate not supplied

New devices in patients with diabetes mellitus.

Explore the source record for details and available documents.

Child↗

PubMedDate not supplied

Intellectual deficits associated with early onset of insulin-dependent diabetes mellitus in children.

Twenty-seven children with early-onset (less than 4 yr) diabetes (EOD), 24 children with late-onset (greater than 4 yr) diabetes (LOD), and 30 sibling controls were compared in their performance on tests of intellectual functioning and school achievement. The results indicated that children with EOD, particularly girls, scored lower than the other groups of diabetic children and siblings on tests of visuospatial (P less than .05) but not verbal ability. Many of the girls with EOD were also having difficulty at school, and several were receiving special education. Children with EOD had more hypoglycemic convulsions than those with LOD. Both convulsions and age of onset were associated with poorer performance on spatial tasks. Girls with EOD had lower spatial test scores regardless of convulsion history, whereas boys with EOD scored lower only if they had had a convulsion.

Achievement↗

PubMedDate not supplied

Cataracts in children with diabetes mellitus.

Explore the source record for details and available documents.

Adolescent↗

PubMedDate not supplied

Insulin resistance developing in children with IDDM.

In a review of the 1000 children with insulin-dependent diabetes mellitus (IDDM) followed at The Hospital for Sick Children, Toronto, between 1970 and 1980, insulin resistance (IR) was noted in 3 after initial sensitivity to exogenous insulin. One was an otherwise typical patient with IDDM. One had cystic fibrosis and is the first such patient with IR to be reported. These two had high insulin antibody titers and responded dramatically to sulfated insulin. The third patient had hyperthyroidism. Although she also had a high anti-insulin antibody titer, IR was controlled only when she was given propylthiouracil. She is the first reported child with IR and hyperthyroidism. The literature on IR in children with IDDM is reviewed. With our 3 patients included, a total of 29 children have been reported. Their mean age is 12.9 yr, 72% are female, and 41% had associated illnesses. Insulin antibodies were elevated in 71% of those in whom measurement was attempted. Of those whose outcome is reported, 67% improved, 21% continued to have IR, and 12% died.

Adolescent↗

PubMedDate not supplied

Self-monitoring of blood glucose: how accurate are children with diabetes at reading chemstrip bG?

Accuracy of self-monitoring of blood glucose (SMBG) using Chemstrip bG (Bio-Dynamics, Indianapolis, Indiana) was studied in 90 randomly selected children with insulin-dependent diabetes mellitus (IDDM). For 28 children (mean age 8.3 +/- 3.6 yr) a parent routinely read the Chemstrip at home. The remaining 62 children (mean age 13.7 +/- 2.8 yr) read the Chemstrip themselves. Each child or parent analyzed 20 capillary blood samples using Chemstrips and answered a questionnaire on SMBG. The accuracy of SMBG of the group was high (mean correlation coefficient = 0.89 +/- 0.05), but consistency of measurement was variable (mean standard deviation = 1.90 +/- 0.57) and there was a general tendency to underread Chemstrips (mean y-intercept = 1.05 +/- 1.48; mean slope = 0.80 +/- 0.17). For each subject, 0-65% (mean of 34%) of readings were within 10% of the laboratory measurement, and 17-100% (mean 68%) within 20%. These results indicate that most subjects were fairly accurate in reading Chemstrips; however, analysis of accuracy is useful in identifying individuals who are inaccurate or inconsistent in SMBG. Continuing supervision of SMBG is necessary in children with IDDM.

Adolescent↗