GASTROINTESTINAL SYMPTOMS AND DIABETES-MELLITUS IN CHILDREN AND ADOLESCENTS

Because it may be difficult to evaluate gastrointestinal diseases in c hildren with insulin-dependent diabetes mellitus (IDDM), this report h ighlights several clinical features unique to diabetes and emphasizes the relationship between gastrointestinal pathology and glycemic contr ol. Two children with IDDM are described whose hyper-glycemia, ketosis , and abdominal pain were the presenting features of H. pylori-positiv e duodenal ulcer disease and acute appendicitis, respectively, A third nondiabetic child developed persistent postprandial hyperglycemia as the initial manifestation of dumping syndrome, These patients illustra te the relationship between glycemic control and gastrointestinal path ology in children with diabetes and the effects of gastrointestinal dy sfunction on glucose regulation in nondiabetic children, In children w ith IDDM, gastrointestinal pathology can be confused with ketoacidosis and complicate diabetes control and management, Early recognition and treatment of the underlying gastrointestinal disease often improves g lycemic control, Furthermore, severe gastrointestinal dysfunction in n ondiabetic children may deleteriously influence glycemic regulation an d may be confused with childhood diabetes.