[Pediatric diabetology at the University Children's Hospital Queen Fabiola in Brussels is 40 years old].

: By the end of medical school at the Free University of Brussels (ULB) in 1969, I began my specialization in pediatrics. Immediately, my mentor, Professor Helmut Loeb led me into pediatric diabetes which was non-existent in Belgium. Forty years later, the diabetes clinic for children and adolescents at the University Children's Hospital Queen Fabiola in Brussels has the largest number of young patients in Belgium, social medical activities and clinical research, with the best protective glycated hemoglobin levels (proven in international comparisons from Hvidore Study Group on Childhood Diabetes) in relation to potentially invalidating complications in the short and long term. Nevertheless, this wasn't obvious, because to stay humanistic, the fight was very hard. Over four decades, hospital life changed: balkanisation of pediatrics at ULB and competition in the same field; overrun by administrative and political power at the expense of medical freedom; weakening of the medical status at university hospitals in order to dominate and break solidarity; emphasis of financial gain instead of better quality of care and treatment. Fortunately, despite all of these pitfalls, some doctors and administrators are still able to maintain non-profit quality care for all and in our interests as a whole. Moreover, Belgian Social Security has recognized pediatric diabetic centers and subsidizes the pluridisciplinary teams of which the standards have been fairly defined. If type 1 diabetes occurs in younger and younger children, the future of pediatric diabetology will also include type 2 diabetes whose rates are exponential in countries where "fast food" reigns along with little physical exercise. Belgium is about 10 years behind what's happening in the United States....