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Early Phase of Juvenile IDDM–Environmental and Genetic Intervention–
Author(s) -
Kitagawa Teruo,
Fujita Hidehiro,
Tsukasa Shintaro,
Hanaoka Yoko,
Uragami Tatsuhiko
Publication year - 1987
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.1987.tb00008.x
Subject(s) - medicine , postprandial , insulin , type 1 diabetes , juvenile , endocrinology , diabetes mellitus , biology , genetics
The clinical appearance in the early phase of two cases of juvenile IDDM detected by urine glucose screening are described. Their postprandial blood glucose and HbAj were maintained without insulin therapy for several months below 180 mg/dl and 8.7% respectively. At three and six months after diagnosis both cases became ketoacidotic and their glucose tolerance deteriorated with a marked decrease of postprandial serum CPR level. There was no high insulin requirement with low CPR level at the time of diagnosis in 12 such patients with the above mentioned slow onset type IDDM. The insulin requirement steadily increased and serum CPR decreased from 12 months after diagnosis. The so‐called honeymoon period was not observed in this group. However, at the time of diagnosis in 24 patients with typical abrupt onset IDDM, there was a high insulin dose requirement with a low level of postprandial CPR value followed by an early decline in the insulin requirement with a temporary increase of CRP value. HLA‐DR4 or DRW9 or both were more freqently observed in patients with abrupt onset type IDDM than in slow onset type IDDM. It may probably be that genetic background as well as environmental factors affect the clinical picture in the early phase of IDDM in children.