الفهرس 
DIABETES MELLITUSOnly 14 pages are availabe for public view
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Abstract
T
his study was primary designed to investigate the association between 2009 (H1N1) virus infection in a cohort of children and adolescents with type 1DM.
This study was carried out on 45 children and adolescents with type 1 diabetes mellitus (32(71%) males and 13(28.9%) females) attending emergency room of pediatric Hospital of Ain Shams University in the period from December 2009 to December 2010.
Another group of 30 age- and sex-matched healthy individuals; 17(56.7%) males and 13(43.3%) females were enrolled as controls. The mean age of patients was (9.69+_4.02) years while that of controls was (10.43+4.38) years, range (2-18) years for both.
All patients and control were subjected to complete history taking, physical examination, radiological assessment by chest X-ray to those with respiratory symptoms, laboratory investigations which included: random blood sugar (RBS), complete blood count (CBC), C-reactive protein (CRP), H1N1 reverse transcriptase–polymerase chain reaction test using (RT-PCR) from nasopharyngeal swabs. Further investigation for patients: glycated hemoglobin concentration (HbA1c%), and those presented with DKA will be further investigated for:
Arterial blood gases (ABG) by blood gas analyzer. Serum electrolytes Na+, K+, s. creatinin, blood urea nitrogen (BUN), liver function test (ALT,AST)and urine ketone by urine ketone test strips.
Statistical analysis was done to evaluate the different studied parameters.
Upon comparison between patients and control subjects: RBS (273.30±87.91mg/dl vs 119.35±29.69 mg/dl, P=0.000), lymphocytic count (3.26+_1.03x103/ul vs 2.488±.693 x103/ul, P=.000), CRP (21.76±12.044mg/l vs 16.973±12.18mg/l P=.032) were significantly higher in diabetic patients than healthy controls.
Diabetic patients with +ve (H1N1) showed significantly higher RBS (292.79±100.10mg/dl vs 234.33±33.02mg/dl P=.016), higher HB (12.87±1.09g/dl vs 11.64+_1.64g/dl, P=.016) higher platelet count (298.63±56.96x103/ul vs 262.13±43.23x103/ul, p=.035) higher, TLC(10.43±3.02x103/ul vs 7.44±2.24x103/ul, P=.002) and higher CRP (27.75±10.29 mg/l vs 9.80±2.56 mg/l, p=.000)when compared with diabetic patients with-ve (H1N1).
Further, newly diagnosed patients presented with +ve (H1N1) and DKA showed higher RBS (356.00 ±41.14 mg/dl vs 246.54±37.5mg/dl, P=.000) and higher TLC (15.22±2.43x103/ul vs 9.42±2.53x103/ul, P=.001) than known diabetic patients
Also cases with +ve (H1N1) had higher RBS (292.79 ±100mg/dl vs 123.10±27.20mg/dl P=0.000), higher hemoglobin (12.87±1.09 g/dl vs 11.85±1.19 gm/dl, p=.007) and higher lymphocytes (3.82±.746x103/ul vs .877±2.91x103/ul P=.000) than control with +ve (H1N1).
Comparison between newly diagnosed patient showed higher platelet (310.57±66.71x103/ul vs 275.58±46.16x103/ul, p=.047), higher TLC (11.49±3.75x103/ul vs 8.50±2.27x103/ul P=.006) and higher CRP (29.56±8.48 vs 18.24±11.8 P=.005) than old patients.
Correlation studies showed significant positive correlations were found between H1N1 and hemoglobin, lymphocytic count, TLC, RBS, CRP (moderate association) and inversely correlated to Platelet (moderate association) P<0.05.
HbA1c was positively correlated to age (p=.004), weight (p=0.000) height (p=.002), RBS (p=.002) and TLC (p=.049).