Diabetes in Children Case Presentation

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Diabetes in ChildrenCase Presentation

• Presented by Maan Mesmeh,M.D.
• Moderator Dr.Omar Abu Hejleh

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• Reem is a 11 1/2 years old Yemeni girl,
  presented with history of
• Weight loss of 1 month duration. ,associated with
  tiredness decreased activity.
• Thirst feeling frequent urination for the last
  2 weeks
• Admitted to a hospital in Yemen found to have
  high blood sugar, referred to Jordan Hospital for
  further management.

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• Review of systems
• History of
• - Polyphagia.
• - Vertigo dizziness ,no tinnitus.
• No history of
• Headache, abdominal pain, sweating, decrease
  in level of consciousness, heat or cold
  intolerance, change in bowel habit, no skin rash
  or joint pain, hair fall or oral ulcers.

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• Past Hx
• Road traffic accident before 2 years.
• Family Hx
• No H/O consanguity.
• Her uncle with D.M. ( 25 yr old)
• Development
• Good school performance.
• Good communication with other people.
• No menstruation.
• SMR

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Physical Examination

• T36.5C , H.R100/min , R.R28/min , BP120/80
• Stature 146 cm (between 25-50th centile).
• Weight 35 kg (25-50th centile).
• Conscious, oriented for time, place persons.
• No signs of respiratory distress.
• No signs of dehydration.
• Not jaundiced or pale.
• Systems examinations within normal.

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Lab results

• WBC 5.28, N 27 , L 63
• Hb 15.6 , Plt 333,000
• Blood glucose 264 mg/dl
• KFT, LFT ABGs were normal
• S. acetone -ve
• Hb A1c 14.5, Anti GAD-ve. ICA -ve

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Hospital Course

• The patient was placed on diabetic diet plus
  regular glucocheck. She received s.c. mixtard
  according to blood glucose.
• Blood sugar was controlled her symptoms
  (polydepsia , polyuria , polyphagia , tiredness
  dizziness) were relieved .

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• Breakfast Lunch Dinner Bedtime
  
• 9/11 B.S 264(admission)
  350
• Mix ---
  8 U
• 10/11 B.S213 232 196
  413
• Mix6 U 4 U 4 U
  4 U
• 11/11 B.S259 235 343
  242
• Mix8 U 4 U 10 U
  ---
• 12/11 B.S285 181 185
  77
• Mix12 U 2 U 8 U
  ---
• 13/11 B.S98
• Mix12 U

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• The family the patient were educated about the
  disease , how to check blood glucose how to
  give mixtard s.c.
• The patient was discharged in good general
  condition to be followed as an outpatient .