[case review] 소아과 - T1DM

목차

1. Diabetes Mellitus
2. Epidemiology
3. Pathophysiology
4. Clinical manifestations
5. Diagnosis
6. Treatment
7. Prognosis

본문내용

Diabetes Mellitus
• Common, chronic, metabolic disease characterized by hyperglycemiaas cardinal biochemical feature
• Heterogeneousdisease
• Distinct genetic patterns as well as other etiologic and pathophysiologic mechanisms that lead to impairment of glucose tolerance
• T1DM: deficiency of insulin secretion due to pancreatic βcell damage
• Most common endocrine-metabolic disorder of childhood & adolescence
• T2DM: insulin resistance occurring at level of skeletal muscle, liver, and adipose tissue

<중 략>

Clinical manifestations
• Initial presentation of T1DM in children: acute onset
• 증상발생후1개월이내에대부분의환자에서진단됨
• 케톤산증
• 20-40%에서T1DM의초기증상으로나타남 • 인슐린분비↓ + 스트레스 호르몬 (에피네프린, 노르에피네프린, 코르티솔, 성장 호르몬, 글루카곤) ↑
• 인슐린 작용 억제 + 과도한 지방 분해 + 케톤체 형성 증가
• Kussmaul respiration, prolonged corrected QT interval, diminished neurocognitive function, coma
• 화농 피부염, 진균 질염

참고 자료

Nelson’s Textbook of Pediatrics, 20th edition
홍창의 소아과학, 11th edition