الفهرس 
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Abstract
Summary
Diabetes mellitus is a common chronic metabolic syndrome
characterized by hyperglycemia as a cardinal biochemical
feature. It’s a serious, debilitating disease, with life-threatening
complications, in addition to its health provision and resource
implications. The most easily recognized symptoms of D.M are
polyuria, polydepsia, weight loss and non specific malaise.
The major forms of diabetes are classified according to those
caused by deficiency of insulin secretion due to pancreatic β-cell
damage (type 1 DM) and those that are a consequence of insulin
resistance occurring at the level of skeletal muscle, liver, and
adipose tissue, with various degrees of β-cell impairment (type 2
DM).
The incidence of DM increased worldwide in the closing
decades of the 20th century.
Screening of high-risk patients for diabetes and prediabetes is
important. Prompt diagnosis and accurate diabetes classification
facilitate appropriate and timely treatment and may reduce the
risk for complications. This is especially important in children
because lifestyle interventions may be successful and the
lifelong risk for complications is greatest.
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This study included 83 children aged from 5 years to 7 years
old diagnosed as type 1 diabetes mellitus, seeking for follow up
and treatment at Health Insurance Organization.
This study aimed at describing the pattern of diabetes mellitus
in the affected children including age, sex distribution,
associated risk factors, presenting symptoms, presence or
absence of complication, associated medical problems,
management plan and therapy.
In this study, full history taking was truly helpful to identify
the sex and age distribution, age of onset of D.M, predisposing
and risk factors including positive family history, positive
consanguinity and early introduction of cow milk in infancy.
Management plan were discussed including measures of
preventions as following a diet regimen and performing a
regular physical exercise.
Full clinical examination including anthropometric measures
of cases permitted detection of complication of diabetes as
(recurrent chest infection, urinary tract infection, upper
respiratory tract infection, peripheral neuropathy, monlial
vaginitis, ……), anthropometric measures allowed assessing
nutritional and developmental state. It also permitted detection
of any associated medical problem.
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116
Laboratory investigation were performed to evaluate the
condition which included routine urine and stool analysis, FBG
& PPBG, CBC and glycated heamoglobin to assess the glycemic
control over the past 3 months.
The study revealed that number of cases is slightly higher in
girls than boys. Increased incidence of onset of diabetes mellitus
at age group 11-14 years which is peripupertal age. Increased
cases of diabetes with increased age.
The present study shows presence of associated risk factors
for developing diabetes mellitus type 1, including positive
family history (39.8%) of cases, positive consanguinity (24.1%)
of cases, early introduction of cow milk (27.7%) of cases.
Results of currents study show that most common presenting
symptom of D.M is polyuria occurred in 90.3% of cases, then
polydepsia comes next (77.1%).
Results of current study shows that 68.7% of cases have one
or more of diabetic complication. Coma is the most common
complication occurred in 28.9 of all cases, presence of
hypercholesterolemia are in 9.6% of cases which follow other
medication to lower blood cholesterol level, nocturnal enuresis
is an annoying problem for cases and parents, it occurred in
16.9% of cases with increased occurrence in boys more than
girls, recurrent urinary tract infection present in 8.4% of cases at
Summary
117
time of examination. Monilial vaginitis 7.2% form an annoying
problems for girls and also oral fungal infection specially
associated with bad hygiene.
Bad school attendance occur in 21.7% of cases with
increased occurrence in boys than girls due to involvement in
work beside presence of diabetic complications.
The study revealed that only 38.6% of cases have a dietary
regimen with increased number in girls than boys. While having
regular activity present in 41% of cases mostly in boys, as it’s
not available for girls in rural areas to perform regular sport or
physical activity.
The study shows that 90.4% of cases follow their insulin
regimen, the remaining 9.6% of cases mostly occurred in boys
aged 12-17 years who don’t care about the condition. While
75.9% of cases have regular blood glucose level by glucose
meter device which is available free of charge by health
insurance organization offered for diagnosed diabetic children.
The study revealed that 68.7% of cases have a combined
therapy of long acting insulin and rapid acting insulin, while
31.3% has monotherapy of one type of insulin. 92.8% of cases
get their insulin via penfill while 7.2% of cases use disposable
syringe.
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118
In this study, HbA1c test were performed to assess the
glycemic state over the past 3 month and used as a predictor for
diabetic complications, 25.3% of cases has a good control,
36.1% has a moderate control while 38.6% has a bad control,
this is attributed to faulty unhealthy dietary habits and lack of
regular physical activity.
Routine laboratory test and CBC, show that 31.3% of cases
have parasitic infestation while 21.7% of cases have nutritional
anaemia, this is explained by unhealthy food habits, lack of
health education and promotion.