Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011854 (type 1 diabetes)
 20,749 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Case report on a child whose type I diabetes mellitus was diagnosed 23 months before the appearance of overt glucose intolerance. In this pre-IDDM stage of DMI were observed secondary enuresis, decreased growth speed, transient hyperglycemia and asymptomatic glycosuria. These alterations may represent the earliest clinical manifestation of impaired beta cell function. Immunologic markers (ICA and/or AAI) of DMI and abnormalities of the first-phase insulin secretion in response to intravenous glucose also may precede by several months the most common clinical picture of type I diabetes as they were detected in this child. If possible, markers and alterations should be tested in such patients and their young relatives with DMI in order to detect high risk individuals who may develop DMI. Such and accurate predictive ability should be a prerequisite to institution of appropriate therapy to preventing further beta cell destruction and severe metabolic decompensation, thus having the potential to reduce morbidity and mortality from new onset DMI.
 ...
PMID:[The non-insulin-dependent phase of type I diabetes mellitus]. 822 May 8

This study examined the relationship between metabolic control and enuresis in youths with type 1 diabetes. Participants were 203 youths with type 1 diabetes at an outpatient pediatric diabetes clinic. Outcome measures included HbA(lc), nocturia, blood glucose, polydipsia, frequency of daytime urination, and diabetic ketoacidosis. The mean fasting blood glucose (FBG) level of children with enuresis (FBG = 192 mg/dl) was significantly higher than that of children without enuresis (FBG = 160 mg/dl, p = .03). Differences in HbA(lc) levels between children with enuresis and those without enuresis approached significance (9.2% vs. 8.6%, p = .07). Findings indicate that metabolic control indices (FBG, HbA(1c), polyuria, and polydipsia) are related to nocturnal enuresis in youths with type 1 diabetes. Further studies should determine the mechanism by which this relationship occurs to initiate appropriate interventions.
 ...
PMID:Metabolic control and nocturnal enuresis in children with type 1 diabetes. 1723 93

Diabetic Ketoacidosis (DKA) is a leading cause of death and disability in children with type 1 diabetes (T1D) and it is generally related to a long duration of misdiagnosed hyperglycaemia-related symptoms. Shortening this latency period could be a winning preventive strategy. It is intuitively easy to achieve this goal when other members with T1D in a family exist, as well as during the follow-up of the relatives of patients with T1D positive for genetic, immunological or metabolic markers. An incidental blood glucose level over 100 mg/dl found in children without history for T1D has been reported as indicative of a progressive beta-cell dysfunction and so it may be recommended for DKA prevention at diabetes diagnosis. More encouraging results have been obtained with a campaign of information promoted in schools and in paediatricians' offices, centred on the earliest symptom of diabetes (nocturnal enuresis in a dry child) as reported by 89% of parents. During 8 years of this campaign, the cumulative frequency of DKA dropped from 78% to 12.5% and its long effects were still observed several years after it was promoted. The Parma campaign obtained a reduction in DKA incidence at diabetes diagnosis never found before. The key-success of this campaign may be attributed to the communication of a valuable and reliable message easy to understand and follow; information toward a large population through school and paediatric consultation; involvement of family paediatricians and Parents' Association; free access to experienced health providers in diabetes diagnosis.
 ...
PMID:Available tools for primary ketoacidosis prevention at diabetes diagnosis in children and adolescents. "The Parma campaign". 1855 26

The aim of the study was to determine the clinical and biochemical characteristics of type 1 diabetes mellitus (DM) at presentation in children younger than 15 years in Croatia during a 9-year period, with special attention to diabetic ketoacidosis (DKA) incidence. The registered data set comprised blood glucose, pH, serum bicarbonate levels, and clinical symptoms at disease manifestation. During the study period, 692 children were diagnosed with type 1 DM. Polydipsia (96.7%), polyuria (96.05%), and weight loss (82.7%) were the most frequent symptoms anticipating disease detection. Enuresis was recorded in 11.55%. A total of 36.41% patients had DKA (pH < 7.3) at disease onset. During the 9-year period, the percentage of children presenting with DKA at time of diagnosis decreased from 41.67% to 33.33% (z = 1.68, p = 0.046). A positive family history of DM, the only factor with an impact on the DKA incidence rate in our population, lowers the probability of the development of ketoacidosis. This study confirms the importance of the detection of the classic symptoms of polyuria, polydipsia, and weight loss in patients with new-onset type 1 DM. The percentage of patients with DKA at diabetes onset decreased during the observed period but is still high and includes one-third of all patients. This is why in every acutely ill child, especially at a younger age, one should evaluate the possibility of type 1 DM to avoid the development of ketoacidosis.
 ...
PMID:Clinical characteristics at presentation of type 1 diabetes mellitus in children younger than 15 years in Croatia. 2214 53

Up to 70% of children with new-onset Type 1 diabetes mellitus (T1DM) present with diabetic ketoacidosis (DKA), with most cases initially assessed by their primary care provider. DKA is the most common cause of death in children with T1DM, mainly related to cerebral edema that occurs at a frequency of 0.15-4.6%. Early recognition of DKA can be improved by increasing the awareness of early clinical symptoms such as enuresis, polyuria and polydipsia. Clinical acumen paired with early assessment of patients with suspected T1DM and known T1DM, particularly if risk factors for DKA are present, can prevent serious complications and fatal outcomes. Urgent referral to specialist centers for suspected new-onset T1DM/DKA is required. A standardized approach is recommended to be followed to ensure successful initial management of DKA, both in the nonspecialist setting before transfer and in the more specialized hospital setting. This article outlines such a management approach.
 ...
PMID:Pediatric diabetic ketoacidosis management in the era of standardization. 3075 63