Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Managing T1D in young children is challenging from medical and psychosocial perspectives. YC-T1D have high insulin sensitivity and nocturnal hypoglycemia is common. Young children have unique developmental challenges including normative dependence upon parental caretaking and labile self-regulation of behavior and emotions, eating , sleep and physical activity that may complicate T1D care. Objective: The aim of the study was to assess the characteristics of insulin therapy regarding type, dose and frequency, as well as degree of glycemic control achieved in young children with diabetes. Methods: Sixty-nine patients with type 1 DM, aged less than five years, following up at diabetes endocrine and metabolism unit (DEMPU), specialized pediatric hospital, Faculty of medicine, Cairo University in the period from March 2015 to June 2016 were recruited in the study. Results: the present study showed that diabetic ketoacidosis necessitating ICU management at diagnosis was present in 49 patients (71%), and hyperglycemia without ketosis in 20 patients (29%). 39/60 cases (65%) with mean HbA1c level {u2265}7.5%. more favourable control in terms of mean HbA1c level was noticed in those using NPH than those on Long acting analogue (8.0±1.3 vs 9.2±1.5, p=0.03) and in cases on regular short acting insulin than in cases on ultra short insulin (7.7±1.3 vs 8.5±1.3%,p=0.05). Ketoacidosis /hyperglycemia was responsible for (76.5%) of hospital readmissions; while hypoglycemia was a less frequent cause for readmission to hospital being reported in 20.6%

Issued also as CD