NON-KETOTIC CHILDHOOD DIABETES- A TYPICAL TYPE 1 OR TYPE 2 DIABETES MELLITUS?

Dipti Sarma, Uma Kaimal Sikia, S. Dutta Chaudhury, Gauhati Medical College, Guwahati.

Aim:To study the clinical profile of nonketotic childhood diabetes and evaluate the existence of a separate entity of type 2 DM in children.

Observations : 42 cases between the age of 0-18 years were seen in the Endocrinology OPD of Gauhati Medical College for a 11/2 year period.  Of these 18 cases were taken for the study on the basis of absence of Ktonuria or any ultrasound evidence f pancreatic calcification.  The male:female ratio was 3:5.  The positive family history was present in 56% cases.  All cases had BMI<18.

All cases had mild osmotic symptoms and weight loss with duration ranging from 1-6 months

The fasting blood sugar were>200mg/dl and 2 hours post prandial blood sugar level between 300-400 mg/dl in all cases.  The urine was negative for ketons in all cases.  Oral hypoglycaemics were tried in 3 patients but a there was no response within one month, all cases were put on insulin.

Conclusion:

Non-Ketotic, early onset diabetes mellitus is becoming an increasingly observed entity in clinical practice

Special tests to assess the beta Cell reserve and insulin resistance will be needed to classify the type of diabetes and to decide the mode of therapy.