Diabetes in Children

Question 1

Q: What is the primary cause of Type 1 Diabetes Mellitus (T1DM)?

Answer 1

A: Autoimmune destruction of pancreatic β-cells leading to lack of insulin secretion.

Question 2

Q: List three environmental triggers associated with T1DM.

Answer 2

A:

Viral infections (e.g., enteroviruses)
Decreased gut microbiome diversity
Diet (e.g., cow’s milk proteins)

Question 3

Q: What are common clinical presentations of T1DM in children?

Answer 3

Polyuria
Polydipsia
Weight loss
Fatigue
Nocturnal enuresis

Question 4

Q: How is T1DM diagnosed according to WHO criteria?

Answer 4

Random blood glucose > 11.0 mmol/L

Fasting blood glucose > 7.0 mmol/L

Question 5

Q: Name two types of insulin regimens used for T1DM.

Answer 5

1- Basal-bolus insulin regimen
2- Insulin pump therapy

Question 6

Q: What is the target fasting blood glucose range for children with T1DM?

Answer 6

A: 4-7 mmol/L

Question 7

Q: What are the key components of DKA management?

Answer 7

A:

• IV fluids with initial bolus and maintenance over 48 hours
• Insulin infusion (0.05-0.1 units/kg/hour)
• Electrolyte monitoring (e.g., KCl in fluids)

Question 8

Q: List two long-term complications of T1DM that require annual monitoring.

Answer 8

1- Diabetic retinopathy screening (from age 12)

2- Diabetic kidney disease (via urine albumin-to-creatinine ratio)

Question 9

Q: What is the HbA1c target for children with diabetes?

Answer 9

A: 48 mmol/mol (6.5%) or lower, adjusted for individual needs.

Question 10

Q: What are the “sick day rules” for children with diabetes?

Answer 10

• Increased blood glucose monitoring
• Check for ketones
• Adjust insulin based on glucose readings
• Seek advice from the diabetes team