A complex disorder, diabetes mellitus afflicts people of every race, sex, age, and cultural background. The form most prevalent in juveniles is insulin dependent diabetes mellitus (IDDM). Although the etiology of IDDM is not yet completely understood, the disease is probably caused by some type of autoimmune response. The diagnosis of this disease has important implications, particularly for the very young. Juvenile IDDM patients may be at risk for neuropsychological problems. In addition, over the long term, IDDM patients may also suffer from numerous other complications. Fortunately though, advances in technology continue to provide these patients with effective tools for managing their condition. With the introduction of new therapeutic modalities, as well as the improvement of existing ones, the adverse health consequences of IDDM may be minimized.
Type I or insulin dependent diabetes mellitus is a severe, chronic metabolic disease. In North America, it affects approximately 3 in every 1,000 children (Grey & Thurber, 1991, p. 302). Thus, IDDM ranks as the most common metabolic disorder of childhood. Worldwide, however, IDDM incidence is somewhat variable. For example, there are 14 new cases per year for every 100,000 children at risk in the United States; in Japan, that same number is less that 1 (Santiago et al., 1992, p. 1025). Although it is known that in people of European extraction IDDM tends to be genetically transmitted, the exact reasons for the disease's variable incidence remain unclear. It may be that in addition to inheritance, environmental factors also play a role in IDDM development.
Diabetes may occur at any age. In juveniles, IDDM is most commonly diagnosed during puberty. About 90% of children will suffer from hyperglycemia. Symptoms associated with the condition include nocturia, polydipsia, and polyuria. In addition, about 75% of juveniles will have experienced weight loss or fatigue...