Clinical analysis of 27 cases with infantile diabetes

Abstract

Objective To investigate the clinical features, diagnosis and treatment of infantile diabetes. Methods The clinical data of 27 infants with type 1 diabetes (T1DM) admitted to our hospital from Apr. 2014 to Jun. 2016 were retrospectively analyzed. SPSS16.0 statistical software was used to carry out t test and chi-square test on relevant data. Results The onset age of diabetes in infants and young children was 1 year to 3 years and 7 months. There were 15 males and 12 females. The onset season was mainly in winter and spring. The fasting blood glucose in cesarean section was significantly higher than that in natural production group (P<0.05) . 12 cases (44.44%) were complicated with respiratory infections before the onset of the disease, including 6 cases of pathogenic detection of viruses, mainly Coxsackie virus. Among them, 14 cases were admitted to hospital with polydipsia and polyuria, 6 cases had fever, cough and mental retardation, 7 cases had elevated blood glucose, 16cases (62.50%) and 6 cases of women with diabetic ketoacidosis (37.50%) . The incidence of diabetic ketoacidosis in male diabetic patients was higher than that in females (62.50% vs 37.50%, χ2=6.49, P<0.05) . With abnormal liver function and dyslipidemia in 2 cases; myocardial enzyme abnormality in 7 cases; abnormal thyroid function in 10 cases; 26 cases of electrolyte abnormality, mainly hyponatremia; 2 cases of positive anti-insulin antibody and 5 cases of positive glutamic acid decarboxylase antibody. Before admission, 13 (35.14%) cases were misdiagnosed, 6 cases were misdiagnosed as bronchopneumonia, 3 cases were misdiagnosed as central nervous system infection, 3 cases were sepsis and 1 case was myocarditis. All patients were treated with insulin. After 7 to 10 days of treatment, the patient’s condition improved and continued to be treated at home. Conclusions The clinical manifestations of infantile T1DM onset are not typical, and it is easy to be associated with ketoacidosis. Infection may be one of the important causes of diabetic ketoacidosis. When the child has an infection and the blood sugar level is high, attention should be paid to the occurrence of diabetic ketoacidosis, to avoid misdiagnosis. Key words: Type 1 diabetes; Infants