Diabetes is the most common metabolic disease in the young.  Juvenile diabetes refers to diabetes in the young. Type 1 diabetes effects 90% of people younger than 25 who have diabetes.

            There is no agreed definition of what is meant by a young person in this context, however most people would refer to a young person as being under 16 or 18 years of age.

.           The Scottish Study Group for the Care of the Diabetes in the Young showed that currently there are nearly 2000 people with diabetes aged under 16 years in Scotland, with an annual incidence of 25 per 100,000 population and a near tripling of new cases in the last 30 years.

Type 1 diabetes, resulting from beta-cell destruction and absolute insulin deficiency, accounts for over 90% of diabetes in young people younger than 25, and is autoimmune in origin.

            Non-type 1 diabetes is recognised with increasing frequency, particularly emerging molecular forms of diabetes, diabetes secondary to pancreatic disease and a rise in type 2 diabetes and other insulin resistance syndromes in the young.

    12-15% of young people under the age of 15 with diabetes mellitus have an affected first degree relative (a positive family history).  Children are thrice as likely to develop diabetes if their father has diabetes rather than their mother.

     While there are known antibody markers of prediction in high-risk subjects, there is no evidence for effective methods of prevention of diabetes.

           There are several randomized trials in progress (e.g. ENDIT, DPT-1, DIPP) investigating different therapies for the prevention of type 1 diabetes. It is anticipated that results will be available in the next five years.

         20% of patients with cystic fibrosis develop secondary diabetes by the age of 20, with an incidence which increases thereafter to 80% by the of age 35.

Limited data suggest that clinical symptoms deteriorate when diabetes develops in cystic fibrosis, although no evidence exists that the presence of diabetes or its treatment affects long-term survival.

     Home-based instruction of the newly diagnosed child or young person appears to be at least as effective as inpatient instruction in terms of glycaemic control and family acceptability over a two-year period. Management in the community using a home-based education programme for patients with newly diagnosed diabetes has been shown also to be cost-effective.

            The evidence on the role of the intensification of therapy in the attempt to achieve as rapid as possible normoglycaemia is inconsistent. In particular, there is no evidence of a sustained effect of any specific insulin therapy on glycaemic control during the first few months after diagnosis.

Reference:

http//www.diabetes.co.uk//juvenile diabetes

 

By: Kristine D. Bugay