Q: What are the symptoms of juvenile diabetes? Can it strike at 8 months of age?

A:Diabetes mellitus in childhood usually presents with polyuria (increased frequency of passing urine), polydipsia (increased thirst), polyphagia (increased appetite), weight loss despite feeding well and weakness. Ketoacidosis is heralded by vomiting, dehydration, abdominal pain, deep and rapid breathing and fruity odor of acetone in breath. Severe acidosis is accompanied by decreasing consciousness and hypotension. The presence of fever is an important clue to associated infection. The diagnosis is confirmed by demonstration of hyperglycemia. Diabetes mellitus can manifest certainly at 8 months of age. It is known to present even in newborn and infants. Two forms are known, transient and permanent. The transient form can manifest as early as by 2 weeks. These children are born at term, but small for the gestation. They have a characteristic ôopen eye - alert faciesö and are emaciated with marked subcutaneous wasting. Onset is sudden with severe dehydration, vomiting and diarrhea. Urine output is high. They may have 'honeyed nappies', polydipsia and polyuria. The high blood sugar can b e controlled only with insulin. Infants with permanent diabetes mellitus may have a congenital anomaly of the pancreas (pancreatic dysgenesis) or the classical type 1 diabetes mellitus seen in older children and adults. The symptoms are similar to the transient form. Most children are small at birth, and are detected on investigations for diarrhoea, fever, lethargy, poor feeding, poor weight gain, dehydration, fast breathing and drowsiness. Those with pancreatic dysgenesis may have associated features of malabsorption.