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Clinical Observation of Juvenile Diabetes Millitus.

Journal of the Korean Pediatric Society 1983;26(6):553-563.
Published online June 30, 1983.
Clinical Observation of Juvenile Diabetes Millitus.
Hae Il Cheong, Dong Gyoon Kim, Yong Choi, Kwang Wook Ko
Department of Pediatrics, College of Medicine, Seoul National University
소아 당뇨병의 임상적 고찰
정해일, 김동균, 최 용, 고광욱
서울대학교 의과대학 소아과학교실
Abstract
Clinical data of 33 children with juvenile diabetes mellitus who were admitted to the Seoul National University Hospital from Jan. 1967 to Feb. 1983 were analyzed retrospectively. Male to female ratio was 10:23, the mean age at onset was 6 10/12 years, and there was considerable seasonal variation with peaks in late winter and spring. Polyuria and polydipsia were noted in all cases as initial symptoms, and the diagnosis of diabetes was established within 2 weeks after onset of initial symptoms in 19 cases(57.6%) and within a month in 26(78.8%). In 14 cases(42.4%), ketoacidosis was accompanied with, onset of disease, and 2 cases of chickenpox infection, 1 case of mumps infection, and 3 case of nonspecific URI preceded onset of symptoms. In 10 cases(30.3%), maturity onset diabetes was noted in family history.On the 1st admission, children with ketoacidosis showed mean blood glucose level of 429 mg/dl, mean serum osmolality of 339 m03m/L, and mean arterial blood pH of 7.139, while those without ketoacidosis did 339 mg/dl, 300 mOsm/L, and 7.369, respectively, and tachypnea, tachycardia, and hemoconcentration were noted more frequently in the former group of cases. Among 20 episodes of ketoacidosis, 13 episodes occured with onset of disease, and 3, after discontinuance of insulin therapy. The mean blood sugar level with ketoacidosis was 403 mg/dl, mean serum osmolality 308 mOsm/L, and mean arterial blood pH 7.10. The mean duration of the 1st admission was 20 days, and at discharge, the mean fasting blood sugar level was 125.6 mg/dl, and average dosage of insulin was 1. 3 unit/kg/day. During follow-up after discharge, honeymoon phase was noted in 8 cases with 5 complete remissions, and lipodystrophy was detected in 2 cases. In 2 cases, artifical pancreas was applied and it has been continued till now for 2 10/12 years in 1 case, while in the other, it was removed after 2 6/12 years of application due to frequent pump obstructions.
Key Words: Juvenile Diabetes Mellitus, Ketoacidosis.


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