A prospective cross sectional study of diabetes mellitus in children and early detection through community screening program in defined group of children
Journal Title: Medpulse International Journal of Pediatrics - Year 2018, Vol 7, Issue 3
Abstract
Background: Prevalence of Diabetes Mellitus among children is very low. Besides, in a developing country like India, the predominant cause of mortality and morbidity in infancy and childhood continue to be infectious, malnutrition and parasitic disorders. As a result, non-communicable diseases such as DM had not received sufficient attention from the health planners and professionals Aims: To study the incidence, clinical features, occurrence of various complications of Diabetes mellitus in children and to study the feasibility of detecting Diabetes Mellitus through a community based screening programme in a defined group of children. Materials and Methods: The study included all patients admitted in pediatric medical wards of BGH from March 2017 to February 2018. All patients suspected or known to have DM were studied through their stay in the hospital and followed up at-least upto three months after discharge. A detailed history and anthropometric measurements were taken from all the patients according to the proforma at the time of admission. The main stress was given on presenting symptoms. Clinical examination included vital data, general and systemic examination. Investigations included the urine sugars, blood glucose levels, serum acetone, glycosylated hemoglobin. To study the feasibility of screening for DM in the community, this project was taken up in a sample size of 1000 school children.1000 school children aged 5 years were screened in one of the lower socio-economic class area for DM (amraiwadi municipal school 1,2,3 and 4). The main screening test used was urine glucose estimation in all and blood glucose estimation in symptomatic children. Results: Of the total number of patients admitted, 18 were diagnosed as DM. 75% of the cases presented with Diabetes Ketoacidosis and its symptoms Breathlessness (50%), Altered sensorium (35%), Vomiting (40%) and Abdominal pain (35%). The complications seen were Hyperglycemic coma 2, Hypoglycemia2, Hypertension (1) and Infections (2). The Community based screening for DM in a defined group of children has shown that of the 1000 children screened none of the urinary or blood samples showed positive results. Conclusion: Diabetes Mellitus (DM) though rare, must be one of the differential diagnosis among patients of all age groups with clinical presentation of breathlessness, altered sensorium/coma, vomiting or abdominal pain as classical symptoms of DM may not be commonly seen. Large scale screening studies must be undertaken for early detection of DM and thus to institute early therapy. Early therapy may itself prolong the remission phase or mitigate the disease process.
Authors and Affiliations
K Rama Santharam, Ananth T, M R Imran
Keywords
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