Diabetes mellitus

Diabetes mellitus is the most common endocrine metabolic disease in childhood, affecting some 100,000 children under the age of 20 in the United States alone. Recognition of impact of this disease on the quality of life, and on morbidity and mortality through the complications that affect the small and large vessels resulting in retinopathy, nephropathy, neuropathy, ischemic heart disease, and large vessel obstruction, has been emphasized by the findings of the National Commission on Diabetes. Increasingly, the accumulated clinical, experimental, and biochemical evidence links the development of these complications to the degree of control of the metabolic disturbances found in diabetes. Hence, as long as reduction of the severity and incidence of these late complications remains a possibility, the pediatrician caring for diabetic children has the enormous responsibility of maintaining as near normal metabolism as is compatible with the well being of each individual child.