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To the Editor.—
During the past decade, epidemiologists dealing with diabetes have accumulated information that indicates that 70% of the new cases of insulin-dependent diabetes mellitus (IDDM) in the young occur from November through March. Most cases occur in persons who are between 5 and 14 years of age (Howard Fishbein, PhD, and Richard Hamman, MD, PhD, oral communications, 1982). Many are initially seen as cases of the flu or viral gastroenteritis. The family or the patient may not mention increased thirst or urination because of the overwhelming nature of the gastrointestinal tract symptoms and the dehydration. Many patients have no family history of diabetes and, thus, are not familiar with the symptoms or dismiss diabetes as not being likely to occur in their family. As a result, there is an increased risk that diabetic ketoacidosis (DKA) may be misdiagnosed as "flu" or "gastroenteritis" during late fall to early spring.
Spratt IL. Detection of Diabetes. JAMA. 1983;249(11):1438. doi:10.1001/jama.1983.03330350020018
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