Recent advances in diabetes mellitus

Abstract 

Evidence suggests that there is a progressive increase in the incidence of type 1 diabetes in recent decades, particularly in young children, which may reflect the increased influence of environmental factors over genetic background in the pathogenesis of the disease. It is now well recognized that pre-pubertal and pubertal glycaemic control are risk factors for the development of complications in later life, and hence the aim of good diabetic care is the attainment of normoglycaemia to prevent complications, whilst allowing normal physical and emotional development of the child. Thus the paediatrician has to be increasingly aware of new developments, which include advances in glucose monitoring, new modes of insulin delivery, use of insulin analogues with improved kinetics, advances in understanding of the pathogenesis of acute and chronic complications, and islet cell transplantation. A number of these developments remain in the field of research. However, others will increasingly become part of routine diabetic care in the near future.

Keywords: type 1 diabetes (T1DM), children, aetiology, complications, treatment

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• f1 Correspondence to: DD. Tel.: +44(0)1223 762944; Fax: +44(0)1223 336996; E-mail: dbd25@cam.ac.uk