Typical presentation in an infant:
(1) vomiting
(2) tachypnea
(3) dehydration
(4) anorexia
(5) tachycardia
(6) altered consciousness
(7) irritability
(8) polyuria and polydypsia (often go unrecognized)
Laboratory findings in diabetic ketoacidosis:
(1) large amounts of ketones in the urine (other conditions usually show small amounts)
(2) serum glucose > 300 mg/dL
(3) acidosis (serum bicarbonate < 15 mEq/L and pH < 7.3)
If the infant is not acutely ill then the following results indicate the present of diabetes:
(1) a random plasma glucose is > 200 mg/dL or
(2) fasting whole blood glucose > 120 mg/dL
Common misdiagnosis:
(1) acute gastroenteritis
(2) viral upper respiratory infection
(3) sepsis
Differential diagnosis for hyperglycemia and glucosuria:
(1) acute febrile illness
(2) epilepsy
(3) central nervous system infection
Differential diagnosis for ketonuria:
(1) persistent vomiting
(2) starvation
(3) inherited metabolic disorder
