DIABETES Problems in the Care of the Infant Diabetic Patient

The unique problems of three infants who developed diabetes mellitus at 13 months of age or younger are discussed. These problems include: the administration of small doses of insulin; the difficulty in attaining control; and the evaluation of urinary sugar content. Suggestions for care are made. DURING the past two years, 47 children were admitted to Children’s Mercy Hospital because of diabetic ketoacidosis. Of these, three were infants less than 13 months of age, and with each infant, the illness presented a unique set of problems which required non-traditional approaches. Examination of the literature showed a number of publications on transient hyperglycemia of infancy’- ’ and a recent review of that subject by Cornblath and Schwartz. ’ In contrast, very little has been written within the past 20 years on diabetes mellitus in infants.5-8 Discussions with several members of the Wilkins Pediatric Endocrine Society revealed that 0.5-1.0 % of diabetic children in the United States are identified at age of one year or less. In this paper we shall present three such youngsters, highlight the common problems, and discuss our ap-proaches to therapy