History of Nocturnal polyuria

A seven-year-old girl presents with a three-week history of nocturnal polyuria. Her mother reports that her daughter seems to have lost weight in the past two months, although she has had a good appetite.

Laboratory tests reveal that the girl’s serum sodium is 130 mEq/L; potassium, 3.2 mEq/L; glucose, 324 mg/dL; and 1+ketones. Urinalysis reveals a specific gravity of 1.025 and moderate glucose and ketones. Her PE is unremarkable.

• What are the differentials for consideration?
• What diagnostic evaluations constitute the ongoing assessment of children with hyperglycemia?
• What are the acute and chronic complications associated with the child’s condition?
• What developmental approach will you use with the child?