THERAPY OF DIABETES-MELLITUS IN CHILDREN AND ADOLESCENTS - AIMS, CRITERIA, RESULTS

We report on the results of longterm treatment of 466 children and adolescents with Type I diabetes (IDDM) between 1980 to 1989. Of these, in, 1989, 240 patients, aged 1 to 20 years, were under continuous treatment, 168 (70%) with CT and 72 (30%) with ICT. For 112 of 466 patients (24%) the medians of all measured HBA1c values were calculated to be less-than-or-equal-to 7.7%, for 53% between 7.8 and 9.6%, and for 24% greater-than-or-equal-to 9.7%. The respective percentages for the ICT patients were found to be 32, 48, and 20%. Medical treatment was accompanied by the continuous offer of education and psychosocial support. In order to reduce the risks for secondary vascular complications, good glycemic control is important in particular during postpubertal years. Therefore children and adolescents need support to obtain both, the acceptance of their disease and the individual responsibility necessary to endure any intensified treatment regimen. Furthermore, the effects of any therapeutic approach should not be measured by glycated haemoglobin only, but in particular by the young subject's individual development and his gain in courage to go on.