Question

1. Compare and contrast diabetes 1 and diabetes 2.
2. What causes diabetic ketoacidosis (DKA), in children? Name signs and symptoms of DKA.

Answer 1

DIABETES TYPES COMPARISON

	TYPE 1	TYPE 2
CAUSE	AUTOIMMUNE DISEASE	INSULIN RESISTANCE
AGE OF ONSET	YOUNG AGE so also called as JUVENILE DIABETES	OLD AGE
PATHOPHYSIOLOGY	BETA CELLS ARE DESTROYED BY IMMUNE CELLS	BETA CELLS DETERIORATE OVER TIME
MODE OF ONSET	ACUTE / SUDDEN	GRADUAL
BODY STRUCTURE	THIN	OFTEN OBESE
chances of KETOACIDOSIS	COMMON	RARE
DISEASE PREVALENCE	LESS	MORE
TREATMENT	INSULIN is the only option available	1 - Lifestyle and diet modification 2 - Oral medications 3 - Insulin

What causes diabetic ketoacidosis (DKA), in children?

1 - JUVENILE DIABETES i.e. type 1 DM

2 - INFECTION like Pneumonia or sepsis

3 - Drugs overdose of steroids

Name signs and symptoms of DKA.

Symptoms are nausea and vomiting, pronounced thirst, excessive urine production and severe abdominal pain.

Sign - "Kussmaul breathing" this is breathing which is rapid, deep and of gasping character, abdominal tenderness,  

In severe DKA, patient may have confusion or even may go incoma.

On physical examination there is usually clinical evidence of dehydration, such as a dry mouth and decreased skin turgor. If the dehydration is profound enough to cause a decrease in the circulating blood volume, a rapid heart rate and low blood pressure may be observed. Often, a "ketotic" odor is present, which is often described as "fruity" or like "pear drops".^[1][9] The smell is due to the presence of acetone.^[11] If Kussmaul respiration is present, this is reflected in an increased respiratory rate.^[9]

Small children with DKA are relatively prone to brain swelling, also called cerebral edema, which may cause headache, coma, loss of the pupillary light reflex, and can progress to death. It occurs in about 1 out of 100 children with DKA and more rarely occurs in adults