CHILDREN WITH DIABETES

Children with Diabetes

[Flotilla Leonard]

[Education 265]

VK01-2010

Health Safety and Nutrition for Young Children

Children With Diabetes

The incidence of type 1 diabetes in childhood has increased rapidly throughout the last two decades in USA. The reason is considered to be environmental factors. There are geographical variations in presentation of type 1 diabetes among countries in Europe with association to the background incidence rate.(Levy-Marchal, 2002) For reasons unidentified even in the smaller geographically characterized area there were differences in clinical presentation between neighboring pediatric clinics.

The diabetes control complications trial (DCCT) showed the better preserved beta cell function in patients with intensive insulin treatment and some early studies in the 1970s and 1980s showed longer remission with more intensive insulin regimens. However, other studies have not verified the leverage on the C-peptide secretion in the longer period by distinct modes of insulin consignment at diagnosis.(Knip, 2008)

Changing environmental factors and varying insulin regimens throughout the last decades could conceivably result in the distinct disease process. The aim of this study was to examine the C-peptide secretion throughout the first years after freshly diagnosed diabetes, the relationship to clinical characteristics at onset, initial therapy, metabolic command, extent of partial remission periods and if there was any secular trends throughout the last 25 years.

This unselected population in the well-defined geographical area with C-peptide analyzed in the standardized manner for 25 years presented an exclusive opening for analyzing the secular tendency of initial presentation at diagnosis of type 1 diabetes. Drop-outs in the study of stimulated C-peptide secretion, inevitable in this type of study of small children in the clinical setting over the long time span, were equally distributed between the cohorts. We have no reason to accept as factual that they were biased with time.(Levy-Marchal, 2002) That all children had the clinical pattern of type ...