[Insulin-dependent diabetes mellitus. Study and follow-up of 100 cases].

UNLABELLED: Clinical records of one hundred pediatric patients affected by IDDM have been analyzed. All the patients have been followed since the beginning of the disease and they have had a check up on average of four months (weight, height, blood pressure, HbA1, C peptide, Triglyceridemia, renal function were evaluated). The method of home-self-monitoring was applied. After four years, and periodically thereafter, microvascular abnormalities were evaluated in all the patients by fluorescein angiography. Neuropathy was evaluated only in symptomatic patients by peripheral nerve conduction. The average follow up period was 6.1 years (range 1-20). RESULTS: the onset of the disease was expressed in 11% of the cases by coma, in 14% by ketoacidosis, in the remaining cases by hyperglycemia only. The severity of initial symptoms has progressively and significantly decreased in the last years. In 7% of the subjects diabetes affected more members of the same family (4 couples of siblings and 3 couples of parent-child). An infection preceding the onset of the disease was present in the history of 23% of the cases. Islet cell antibodies were found in 83% of the studied cases at the onset of the disease. In 80 out of the 100 patients a detailed history has been obtained about the occurrence of ketoacidosis episodes after the first admission and about the occurrence of severe hypoglycemic crises (seizures and/or coma). 17% of the patients presented at least one ketoacidosis episode after the first admission (the main cause was infection before 12 years of age, an emotional problem thereafter).(ABSTRACT TRUNCATED AT 250 WORDS)