PDF Diploma in Clinical Medicine and Surgery

Diabetes Mellitus in Children: Type 1 and Type 2, Presentation, Management and Cerebral Oedema

A paediatric deck by an MBChB year-V presenter on the two major forms of childhood diabetes - type 1 from pancreatic beta-cell damage and failed insulin secretion, type 2 from insulin resistance at the skeletal muscle, liver and adipose tissue - with their presentation, diagnosis and management - the daily requirement for exogenous insulin, self glucose monitoring and dietary attention - and the ketoacidosis picture with ketones excreted in the urine and the fruity breath odour. The closing section is the dangerous one: cerebral oedema in diabetic ketoacidosis, its mannitol protocol with a repeat dose if there is no response in 15 to 30 minutes, elevating the head of the bed to 30 degrees in the midline position, and intubation for impending respiratory failure from severe neurologic compromise.

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