AIM To describe the characteristics of diabetes diagnosis, insulin therapy regarding type, dose and frequency also the degree of glycemic control achieved in toddlers and preschoolers coming from families with limited resources. METHODS Over one year, 69 toddlers and preschoolers clinically diagnosed as type 1 diabetes were included. Data related to presentation at diagnosis, insulin therapy and glycemic control was reviewed from patients' care givers and medical records. RESULTS Diabetic ketoacidosis (DKA) was recorded in 71% of the children at initial diagnosis. The mean time since diabetes diagnosis was 2 ± 1 years. Most of children (65/69, 94%) were on basal-bolus regimen while four (6%) were on basal insulin only. NPH and long acting analogues were used as basal insulin in (74%) and (26%). Regular insulin and rapid acting analogues were used as bolus insulin (27%) and (73%).The mean frequency of daily self monitoring of blood glucose was (2.9 ± 1). The arithmetic mean of HbA1c done over past 6 months to one year before inclusion in the study was 8.2 ± 1.5% (66 ± 12 mmol/mol) with 65% having HbA1c ≥ 7.5% (≥58 mmol/mol). CONCLUSION Toddlers and preschoolers with diabetes coming from families with limited resources frequently present with DKA at diagnosis and have suboptimal self-monitoring of blood glucose and glycemic control. NPH is more commonly used in this age group, combined with postprandial rapid analogues and less commonly preprandial regular insulin and that yields more favorable HbA1c but with a greater risk of hypoglycemia. The most common cause of hospital readmission was ketoacidosis and uncontrolled hyperglycemia.

中文翻译：

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资源有限的家庭的学步儿童和学龄前儿童的糖尿病诊断和控制特征：单中心经验。

目的描述糖尿病诊断的特点，有关类型，剂量和频率的胰岛素治疗，以及来自资源有限家庭的学步儿童和学龄前儿童的血糖控制程度。方法一年多来，共包括69名临床诊断为1型糖尿病的学步儿童和学龄前儿童。从患者的护理人员和病历中回顾了与诊断，胰岛素治疗和血糖控制的表现有关的数据。结果初诊时有71％的儿童患有糖尿病酮症酸中毒（DKA）。自糖尿病诊断以来的平均时间为2±1年。大多数儿童（65 / 69，94％）接受基础推注治疗，而四名儿童（6％）仅接受基础胰岛素治疗。NPH和长效类似物在（74％）和（26％）中用作基础胰岛素。常规胰岛素和速效类似物分别用作推注胰岛素（27％）和（73％）。每日自我血糖监测的平均频率为（2.9±1）。纳入研究前的6个月至一年内，HbA1c的算术平均值为8.2±1.5％（66±12 mmol / mol），其中65％的HbA1c≥7.5％（≥58mmol / mol）。结论来自资源有限的家庭的糖尿病学龄前儿童和学龄前儿童在诊断时经常出现DKA，并且对血糖和血糖控制的自我监控欠佳。NPH在该年龄组中更常用，与餐后快速类似物和餐前常规胰岛素结合使用，产生更有利的HbA1c，但发生低血糖的风险更大。住院再住院的最常见原因是酮症酸中毒和不受控制的高血糖症。