Abstract
Diabetes mellitus is the most common endocrine/metabolic disorder of childhood, with important consequences for physical and emotional development. It is caused by a deficiency of insulin secretion (type 1 diabetes), or decreased insulin action (type 2 diabetes of youth), or both (see the section on other recognizable types of diabetes). Hyperglycemia, caused by abnormal metabolism of carbohydrates, is the hallmark finding of all types of childhood diabetes. In addition to hyperglycemia, untreated diabetes results in altered metabolism of protein and fat, which can negatively impact growth and development. Early detection and treatment of diabetes in children is imperative, and correct classification ensures that disease-specific therapy is utilized.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the diagnosis and classification of diabetes mellitus. American Diabetes Association: Clinical Practice Recommendations 2002. Diabetes Care 2002; 25 (1): S5 — S20.
American Diabetes Association. Position Statement: Standard of medical care for patients with diabetes mellitus. American Diabetes Association: Clinical Practice Recommendations 2002. Diabetes Care 2002; 25 (1): S33 - S49.
Nerup J, Mandrup-Poulsen T, Molvig J. The HLA-IDDM association: Implications for etiology and pathogenesis of IDDM. Diabetes Metab Rev 1987; 3: 779.
Riley WI, Winter WE, Mclaren NK. Identification of insulin-dependent diabetes mellitus before onset of clinical symptoms. J Pediatr 1988; 112: 314.
American Diabetes Association. Type 2 diabetes in children and adolescents. Diabetes Care 2000; 23: 381–389.
Fagot-Campagna, Pettit, DJ, Egelgan, MM, et al. Type 2 diabetes among North American children and adolescents an epidemiologic review and public health perspective. J. Pediatr 2000; 136: 664–672.
Fagot-Campagna, A, Narayan, KMV. Type 2 diabetes in children. Br Med J 2001; 322: 377.
Winter WE, Maclaren NK, Riley WJ, et al. Maturity-Onset diabetes of youth in Black Americans. N Engl J Med 1987; 316: 285.
Kyllo CJ, Nuttall FQ. Prevalence of diabetes mellitus in school-age children in Minnesota. Diabetes 1978; 27: 57.
Kenny, S.J., Aubert, RE, Geiss, LS. Prevalence and incidence of insulin dependent diabetes mellitus. National Instutues of Health Proceedings, 2001.
Calnan M, Peckham CS. Incidence of insulin dependent diabetes in the first 16 years of life. Lancet 1977; 1: 589.
Holmgren G, Samuelson G, Hermansson B. The prevalence of diabetes mellitus: A study of children and their relatives in a northern Swedish county. Clin Genet 1974; 5: 465.
Cowie, CC, Eberhardt, MS. Sociodemographic characteristics of persons with diabetes. Proc Natl Instit Health.
LaPorte RE, Fishbein HA, Drash AL, et al. The incidence of insulin dependent diabetes mellitus in Allegheny County, Pennsylvania (1965–1976). Diabetes 1981; 30: 279.
LaPorte RE, Dorman JS, Orchard TJ. Preventing insulin dependent diabetes mellitus: the environmental challenge. Br Med J 1987; 295: 479.
Bloch CA, Clemons P, Sperling MA. Puberty decreases insulin sensitivity. J Pediatr 1987; 110: 481.
Amiel SA, Sherwin RS, Simonson DC, et al. Impaired insulin action in puberty. A contributing factor to poor glycemic control in adolescents with diabetes. N Engl J Med 1986; 315: 215.
Craighead JE. Current views on the etiology of insulin-dependent diabetes mellitus. N Engl J Med 1978; 299: 1439.
MacCuish AC, Irvine WJ. Autoimmunological aspects of diabetes mellitus. Clin Endocrinol Metab 1975; 4: 435.
Drash AL. The etiology of diabetes mellitus. N Engl J Med 1978; 300: 1211.
Atkinson, MA, Mclaren, NK. The pathogenesis of insulin-dependent diabetes mellitus. N Engl J Med 1994; 331: 1428.
Martin, S, Pawlowski, B, Greulich, B, et al. Natural course of remission in IDDM during 1st year after diagnosis. Diabetes Care 1992; 15 (1): 66–74.
Neufeld M, MacLaren NK, Riley NJ, et al. Islet cell and other organ-specific antibodies in U.S. Caucasians and blacks with insulin-dependent diabetes mellitus. Diabetes 1980; 29: 589.
Irvine WF, McCallum CF, Gray RS, et al. Pancreatic islet-cell antibodies in diabetes mellitus correlated with the duration and type of diabetes, coexistent autoimmune disease and HLA type. Diabetes 1977; 26: 138.
Dobersen MJ, Scharff JE, Ginsberg-Fellner F, et al. Cytotoxic autoantibodies to beta cells in the serum of patients with insulin dependent diabetes mellitus. N Engl J Med 1980; 303: 1493.
MacLaren NK, Huang SW, Fogh J. Antibody to cultured human insulinoma cells in insulin-dependent diabetes. Lancet 1975; 1: 997.
Huange SW, MacLaren N. Insulin-dependent diabetes: A disease of autoaggression. Science 1976; 192: 64.
Tam AC, Dean BM, Schwarz G, et al. Predicting insulin-dependent diabetes. Lancet 1988; 1: 845.
Nerup F, Platz P, Ortved-Anderson O, et al. HLA antigens and diabetes mellitus. Lancet 1974; 2: 864.
Rubinstein P, Suciu-Foca N, Nicholson JF. Genetics of juvenile diabetes mellitus. N Engl J Med 1977; 297: 1036.
Deschamps I, Lestradet H, Bonati C, et al. HLA genotype studies in juvenile insulin-dependent diabetes. Diabetologia 1980; 19: 189.
Rotter JI, Hodge SE. Racial differences in juvenile-type diabetes are consistent with more than one mode of inheritance. Diabetes 1980; 29: 115.
Rotter JI, Rimoin DL. Heterogeneity in diabetes mellitus-update 1978. Diabetes 1978; 27: 599.
Rosenberg LE, Kidd KK. HLA and disease susceptibility: A primer. N Engl J Med 1977; 297: 1060.
Pyke DA. Diabetes: The genetic connections. Diabetologia 1979; 17: 333.
Gamble DR. An epidemiological study of childhood diabetes affecting two or more siblings. Diabetologia 1980; 19: 341.
Fleegler FM, Rogers KD, Drash AL, et al. Age, sex and season of onset of juvenile diabetes in different geographic areas. Pediatrics 1979; 63: 374.
Yoon JW, Austin M, Onodera T, Notkins AL. Virus-induced diabetes mellitus: Isolation of a virus from the pancreas of a child with diabetic ketoacidosis. N Engl J Med 1979; 300: 1173.
Rayfield EJ, Seto Y. Viruses and the pathogenesis of diabetes mellitus. Diabetes 1978; 27: 1126.
Fukagawa, NK, Minaker, LL, Rowe, JW, et al. Glucose and amino acid metabolism in aging man. Differential effects on insulin. Metabolism 1988; 37: 371–377.
Schade DS, Eaton RP. The temporal relationship between endogenously secreted stress hormones and metabolic decompensation in diabetic man. J Clin Endocrinol Metab 1980; 50: 131.
Felig P, Wahren J, Sherwin R, et al. Insulin, glucagon, and somatostatin in normal physiology and diabetes mellitus. Diabetes 1976; 25: 1091.
Raskin P, Unger RH. Hyperglucagonemia and its suppression: Importance in the metabolic control of diabetes. N Engl J Med 1978; 299: 433.
Cryer PE, Gerich JE. Glucose counter-regulation, hypoglycemia, and intensive therapy in diabetes mellitus. N Engl J Med 1985; 313: 232.
Levy-Marshall C, Patterson CC, Green A, EURODIAB ACE Study Group. Geographical variation of presentation at diagnosis of type 1 diabetes in children: the EURODIAB Study. Dlabetalogia 2001; 44: B75 - B80.
Sperling MA. Diabetic ketoacidosis. Pediatr Clin N Am 1984; 31: 591.
Foster DW, McGarry JD. The metabolic derangements and treatment of diabetic ketoacidosis. N Engl J Med 1983;309:159,.
Kreisberg RA. Diabetic ketoacidosis: New concepts and trends in pathogenesis and treatment. Ann Intern Med 1978; 88: 681.
Carroll MF, Schade DS. Ten pivotal questions about diabetic ketoacidosis. Answers that clarify new concepts in treatment. Postgrad Med 2001; 110 (5): 89–95.
Duck SC, Wyatt DR. Factors associated with brain herniation in the treatment of diabetic ketoacidosis. J Pediatr 1988; 113: 10.
Siberry GK, lannone R (eds.). The Harriet Lane Handbook, 15th ed. Mosby, St. Louis, MO, 2000.
Hammeke M, Bear R, Lee R, et al. Hyperchloremic metabolic acidosis in diabetes mellitus. Diabetes 1978; 27: 16.
Harris GD, Fiordalisi I, Finberg L. Safe management of diabetic ketoacidemia. J Pediatr 1988; 113: 65.
Kanter Y, Gerson JR, Bessman AN. 2,3-Diphos-phoglycerate, nucleotide phosphate, and organic and inorganic phosphate levels during the early phases of diabetic ketoacidosis. Diabetes 1977; 26: 429.
Low-dose insulin infusion in the treatment of diabeteic ketoacidosis: bolus versus no bolus. J. Pedatr 1980;96(1):36–40.
Harris GD, Fiordalisi I Harris WL, et al Minimizing the rjisk of brain herniation during treatment of diabetic ketoacidemia: a retropective and prospective study. J Pediatr 117: 22.
Morris LR, Murphy MB, Kitabchi AE. Bicarbonate therapy in severe diabetic ketoacidosis. Ann Intern Med 1986; 105 (6): 836–840.
Witters LA, Ohman JL, Weir GC, et al. Insulin antibodies in the pathogenesis of insulin allergy and resistance. Am J Med 1977; 63: 703.
Bougneres PF, LaJldier F, Lemmell C, et al. Insulin pump therapy in young children with type I diabetes. J Pediatr 1990; 105: 212.
Tamborlane, WV, Press, CM. Insulin infusion pump treatment of type 1 diabetes. Pediatr. Clin N Am 1984; 31 (3): 721–734.
Boland EA, Grey M, Oesterle A, et al. Continuois subcutaneous insulin infusion. A new way to lowr risk of sever hypoglycemia, imporve metabolic control, and enhance coping in adolecents with type 1 diabetes. Diabetes Care 1999; 22 (11): 1779–1784.
Tamborlane WV, Press CM. Insulin infusion pump treatment of type I diabetes. Pediatr Clin N Am 1984; 31: 721.
Minimed. Fredrickson, ed. Establishing and verifying basal rates. The insulin pump therapy book. Insights from the experts. Minimed, 1995.
The DCCT Research Group. The effect of intensive treatment o diabetes on the development and progression of long-term complications in sinuslin-dependent diabetes mellitus. N Engl J Med 1993; 329: 977–986.
Sonksen PH, Judd SL, Lowy D. Home monitoring of blood-glucose: Method for improving diabetic control. Lancet 1978; 1: 729.
Goldstein DE, Walker B, Rawlings SS, et al. Hemoglobin Alc levels in children and adolescents with diabetes mellitus. Diabetes Care 1980; 3: 503.
Mogensen CW. Mangement of diabetic renal involvement and disease. Lancet 1988; 1: 867.
Sperling, MA. Hypoglycemia, In: Behrman, Kliegman, Arvin, eds. Nelson Textbook of Pediatrics, 15th ed. Saunders, Philadelphia, 1996.
Santiago JV, Clarke WL, Shah SD, Cryer PE. Epinephrine, norepinephrine, glucagon, and growth hormone release in association with physiological decrements in the plasma glucose concentration in normal and diabetic man. J Clin Endocrinol Metab 1980;51:877,.
Rosenbloom AL, Giordano BP. Chronic over-treatment with insulin in children and adolescents. Am J Dis Child 1977; 131: 881.
Gale EAM, Kurtz AB, Tattersall RB. In search of the Somogyi effect. Lancet 1980; 2: 279.
Bolli G, Gottesman I, Campbell P, et al. Glucose counter-regulation and waning of insulin in the Somogyi phenomenon. N Engl J Med 1984; 311: 1214.
Campbell P, Bolli G, Cryer P, et al. Pathogenesis of a dawn phenomenon in patients with insulin-dependent diabetes mellitus. N Engl J Med 1985; 312: 1473.
Bantle JP. The dietary treatment of diabetes mellitus. Med Clin N Am 1988; 72: 1285.
Franz MJ, ed. A Core Curriculum for Diabetes Education, 4th ed. American Association of Diabetes Educators, 2001.
Tamborlane W, Held N. Diabetes. In: Tamborlane W, ed. The Yale Guide to Children’ s Nutrition. Yale University Press, New Haven, 1999.
Weinger K, O’Donnell KA, Ritholz MD. Adolescent views of diabetes-related parent conflict and support: A focus group analysis. J Adoles Health 2001; 9: 330–336.
Hardin DS, Azzarelli B, Edwards J, et al. Mechanisms of enhanced insulin sensitivity in endurance trained athletes. J Clin Endocr Metab 1995; 80: 2437–2446.
Landt KW, Campaigne BN, James FW, et al. Effects of exercise training on insulin sensitivity in adolescents with type I diabetes. Diabetes Care 1985; 5: 461–465.
Horton ES. Exercise and diabetes mellitus. Med Clin N Am 1988; 72: 1301.
Zinman G, Murray FT, Vranic M, et al. Gluco-regulation during moderate exercise in insulin treated diabetics. J Clin Endocrinol Metab 1977; 45: 641.
Diabetes in America: Diabetes Data Compiled 1984. US Department of Health and Human Services Publication No. 85–1468 (NIH). US Government Printing Office, Washington, DC, 1985.
Leslie ND, Sperling MA. Relation of metabolic control to complications in diabetes mellitus. J Pediatr 1986; 108: 491.
Skyler JS. “Control” and diabetic complications. Diabetes Care 1978;3:204.
Winter WE, Maclaren NK. Type I insulin dependent diabetes: An autoimmune disease that can be arrested or prevented with immunotherapy? Adv Pediatr 1985; 32: 159.
Cudworth AG, Gorsuch AN, Wolf E, Festeinstein H. A new look at HLA genetics with particular reference to type-1 diabetes. Lancet 1979; 2: 389.
Bougneres PF, Carel JC, Castano L, et al. Factors associated with early remission of type I diabetes in children treated with cyclosporine. N Engl J Med 1988; 318: 663.
Sutherland, DER, Goetz FC, Chin PL, et al. Pancreas transplantation. Pediatr Clin N Am 1984; 31: 735.
Lacy PE, Davie JM Transplantation of pan-creatic islets. Annu Rev Immunol 1984;2:183,.
Haffner, SM, Stern, MP, Hazuda HP. Hyperinsulinemia in a population at high risk for non-insulindependent diabetes mellitus. N Engl J Med 1986; 315: 220–224.
Pinhas-Hamiel O, Dolan LM, Daniels SR. Increased inscidenc e of non-insulin dependent diabetes mellitus among adolescents. J Pediatr 1996; 12: 608–615.
Haffner SM, Mithinea H, Gaskel SP, Stern MD. Decreased insulin secretion and increased insulin resistance are independently related to the 7 year risk of NIDDM. Diabetes 1995; 49: 1386–1391.
Hardin DS, Yafi M, Brosnan P. Clinical characteristics of patients with type 2 diabetes of youth. Diabetes 2001; 50 (2): 225.
Polonsky KS, Sturis J, Bell GT. Non-insulin dependent diabetes mellitus-A genetic program failure of the beta cell to compensate for insulin resistance N Engl J Med 1999; 334: 777–783.
Caprio S, Sherwin R, Evans K, Belous A, Tamborlane W. Early phase insulin secretion is normal in obese adolescents with impaired glucose tolerance. Diabetes 2002; 50 (2): 224.
Deitz WH. Overweight and precursors of type 2 diabetes mellitus in children and adolescents. J Pediatr 2001; 138: 453, 454.
Deckelbaum RJ, Williams CL. Childhood obesity: the health issue. Obesity Res 2001; 9: 2395–243S.
Bjorntorp P. Hazards in subgroups of human obesity. Eur J Clin Invest 1984; 14: 239–241.
Triano RP, Flegal KM. Overweight children and adolescents: Description epidemiology, and demographics. Pediatrics 1998; 101: 497–504.
Ludwik B, Nolan JJ, Baloga J, Saks D, Olefsky J. Effects of obesity on insulin resistance in normal subjects and patients with NIDDM. Diabetes 1995; 44: 1121–1125.
Kolterman OG, Insel J, Olefshy JM. J Clin Invest 1980; 65: 1272–1284.
Hardin DS, Maianu L, Sorbel J. Genetic factors are more important than environment in determining insulin sensitivity, muscle GLUT4 content and related metabolic factors in normal twins. Diabetes 1994; 43: 73.
Vaag A, Henriksson JE, Madsbad S, et al. Insulin secretion, insulin action, and hepatic glucose production in identical twins discordant fro NIDDM. J Clin Invest 1995; 95: 690–698.
Mokdad AH, Serdula MK, Dietz WH, et al. The spread of the obesity epidemic in the United States. JAMA 1999; 282: 1519–1522.
Waldhausl W, Kleinberger G, Korn A, et al. Severe hyperglycemia: effects of rehydration on endocrine derangements and blood glucose concentration. Diabetes 1979; 28: 577.
Johnson WG, Hinkle LK, Carr RE, et al. Dieteary and exercise interventions for juvenile obesity: long-term effect of behavioral and public health models. Obesity Res 1997; 5: 257–261.
Dietz WH, Gortmaker SL. Preventing obesity in children and adolescents. Annu Rev Public health 2001; 22: 337–353.
Hardin DS, Hebert JD, Bayden T, Dehart M, Mazur L. Treatment of childhood syndrome X. Pediatric 197; 100: 1–4.
Jones KE, Arslanian S, Peterkova VA, et al. Effect of metformin in pediatric patients with type 2 diabetes: a randomized controlled trial. Diabetes Care 2002; 25: 89–94.
Zhurick-Yafi M, Brosnan P, Hardin DS. Treatment of type 2 diabetes of youth. J Pediatr Endocr Diabetes, in press.
Shield JPH, Howell WM, Temple KM. Neonatal diabetes. Diabetes Care 1997; 20: 1045, 1046.
Shield JPH, Gardner RJ, Wadswroth EJK, et al. Antiopathology and genetic basis of neonatal diabetes. Arch Dis Child 1997; 76: F39–42.
Temple IK, Gardner RJ, Mackay DJG, et al. Transient Neonatal Diabetes. Widening the understanding of the etiopathogenesis of diabetes. Diabetes 2000; 49: 1359–1366.
Schiff D, Colle E, Stern L. Metabolic and growth patterns in transient neonatal diabetes. N Engl J Med 1972; 287: 119.
Pagliara AS, Karl IE, Kipnis DB. Transient neo-natal diabetes: delayed maturation of the pancreatic beta cell. J Pediatr 1973; 82: 97.
Daugberg PS. A case of permanent diabetes in a neonate. Dan Med Bull 1981; 28: 216.
Shield JPH, Baum JD. Is transient neonatal diabetes a risk factor for diabetes in later life? Lancet 1993; 341: 683.
Temple JK, James RS, Crolla JA, et al. An imprinted gene(s) for diabetes? Nat Genet 1995; 9: 110–112.
Hattersley AT. Maturity-onset diabetes of the young. Balliere’s Clin Pediatr 1996; 4: 663–680.
Winter WE, Kakamura M, House DV. Monogenic diabetes melltus in youth the MODY syndromes. Pediatr Endocr 1999; 28: 765–785.
Velho G, Lathrop GM, Froguel P. A gene for maturity onset diabetes of the young (MODY) maps to chromosome 12Q. Nat Genet 1995; 9: 418–423.
Velho G, Froguel P. Genetic, metabolic and clinical characteristics of maturity onset diabetes of the young. Eur J Endocrinol 1998; 138: 233–239.
Guazzarotti L, Bartolotta E, Chiarelli F. Maturity Onset diabetes of the young.(MODY): a new challenge for pediatric diabetologists. J Pediatr Endocr Metab 1999; 12: 487–497.
Moran A. Abnormal glucose metabolism in cystic fibrosis. J Pediatr 1998; 133: 10–17.
Moran A, Hardin D, Rodman, et al. The diagnosis, management and treatment of patients with cystic fibrosis related diabetes. Res Clin Prac 1999; 45: 61–73.
Finkelstein SM, Wielinski CL, Ellitt, GR. Diabetes mellitus associated with cystic fibrosis. J Pediatr 1988; 112: 373–377.
Lanng S, Thoresteinsson B. Lund-Andersen C, et al. Diabetes miltus in Danch cystic fibrosis patients. Prevalence and late diabetic complications. Acta Paediatr Scand 1994; 83: 72–77.
Mohan V, Alagappan V, Snehalatha C, et al. Insulin and C peptide responses to glucose laid in cystic fibrosis. Diabetes Metab 1985; 11: 376–379.
Hardin DS, Leban A, Lukenbaugh S. Seigheimer, DK Insulin resistance is associated with decreased clinical status in cystic fibrosis J Pediatr 1997; 6: 948–956.
Hardin DS, Leblanc A, Para L, Seilheimer DK. Hepatic insulin resistance and defects in substrate utilization in cystic fibrosis. Diabetes 1999; 48: 1082–1087.
Austin A, Kahan SC, Orenstein D, et al. Roles of insulin resistance and beta cell dysfunction in the pathogenesis of glucose intolerance in cystic fibrosis. J Clin Endocr Metab 1994; 79: 80–85.
Zemel BS, Kawchak DA,Cnaan A, et al. Prospective evaluation of resting energy expenditure, nutritional status, pulmonary function, and genotype in children with cystic fibrosis. Pediatr Res 1996; 40: 578–586.
Kraemer R, Ruderberg A, Hadorn B, Rossi E. Relative underweight in cystic fibrosis and its prognostic value. Acta Paediatr Scand 1978; 67: 33–35.
Hardin DS, Lebanc A, Lukenbaugh S, et al. Increased rates of proteolysis associates with insulin resistance in cystic fibrosis. Pediatris 1998; 10: 948–946.
Zipf WB, Kien CL, Horswill CA, McCoyu KS. Effects of feeding on daily protein turnover balance (DPTB) in cystic fibrosis (CF). Pediatr Res 1991; 30: 178.
Geffner ME, Kaplan SA, Bersch N, et al. Leprechaunism: in vitro insulin action despite genetic resistance. Pediatr Res 1987; 22: 286.
Acillii D. Molecular defects of the insulin receptor gene. Diabetes Metab Rev 1995; 11: 47–62.
Longo N, Wang Y, Pasquali M. Progressive decline in insulin levels in Rabson-Mendenhall syndrome. J Clin Endocr Metab 1999; 84: 2623–2629.
Flier JS, Kahn CR, Roth J. Receptors, antireceptor antibodies and mechanisms of insulin resistance. N Engl J Med 1979; 300: 413.
Seip M, Trygstad O. Generalized lipodystrophy, congenital and acquired (lipoatrophy). Acta Paediatr 1996; 413: 2–28.
Seip M. Liposdystrophy and gigantism with associated endocrine manifestations: a new diencephalic syndrome. Acta Paediatrica 1959; 48: 555–574.
Copeland K, Nair KS, Kaplowitz PD, et al. Discordant metabolic actions of insulin in extreme lipodystrophy of childhood. J Clin Endocri Metab 1993; 77: 1240–1245.
Helderman JH, Elahi D, Anderson DK. Prevention of the glucose intolerance of thiazide diuretics by maintanence of body potassium. Diabetes 1983; 32: 106–111.
Walli RK, Herfort O, Michi GM. Treatment with protease inhibitors associated with peripheral insulin resistance and impaired oral glucose tolerance in HIV-1 invecte patients. AIDS 1998; 12: F167–173.
Jindal RM, Sidner RA, Milgrom ML. Post-transplant diabetes mellitus. The role of immunosuppression. Drug Exp Drug Safety 1997;16(4).
Charan VD, Desai N, Singh AP, Choudhry VP. Diabetes mellitus and pancreatitis as a complication of L-asparaginase therapy. Indian Pediatr 1993;30(6):809,810.
Jacobson AM, Leibovich JB. Psychological issues in diabetes mellitus. Psychosomatics 1984; 25: 7.
Cerreto MC, Travis LB. Implications of psychological and family factors in the treatment of diabetes. Pediatr Clin N Am 1984; 31: 689.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2003 Springer Science+Business Media New York
About this chapter
Cite this chapter
Hardin, D.S. (2003). Diagnosis and Management of Diabetes in Children. In: Meikle, A.W. (eds) Endocrine Replacement Therapy in Clinical Practice. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-375-0_10
Download citation
DOI: https://doi.org/10.1007/978-1-59259-375-0_10
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-61737-416-6
Online ISBN: 978-1-59259-375-0
eBook Packages: Springer Book Archive