Diabetes mellitus in childhood: an emerging condition in the 21st century

• Main Authors: Thais Della Manna, Nuvarte Setian, Roberta Diaz Savoldelli, Dulce Rondina Guedes, Hilton Kuperman, Hamilton Cabral Menezes Filho, Leandra Steinmetz, Louise Cominato, Vaê Dichtchekenian, Durval Damiani
• Format: Article
• Language: English
• Published: Associação Médica Brasileira
• Series: Revista da Associação Médica Brasileira
• Subjects: type 1 diabetes mellitus; child; adolescent; epidemiology; metabolic control
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302016000600594&lng=en&tlng=en

Summary The International Diabetes Federation (IDF-2015) estimates the existence of 30,900 children under 15 years old with type 1 diabetes mellitus (DM1) in Brazil, and an increase of 3.0% per year is expected. This review focused on meta-analysis and pediatric diabetes update articles in order to draw attention to the need of planning coping strategies to support this serious public health problem in coming years. DM1 is considered an immuno-mediated disease with a complex transmission influenced by genetic and environmental factors responsible for a gradual destruction of the insulin producing pancreatic beta cells. Seroconversion to DM1-associated autoantibodies and abnormalities in metabolic tests that assess insulin secretion and glucose tolerance can be used as predictive criteria of beta cells functional reserve and the onset of the clinical disease. Symptomatic DM1 treatment is complex and the maintenance of good metabolic control is still the only effective strategy for preserving beta cell function. Disease duration and hyperglycemia are both risk factors for the onset of chronic vascular complications that negatively affect the quality of life and survival of these patients. In this regard, health teams must be trained to provide the best possible information on pediatric diabetes, through continuing education programs focused on enabling these young people and their families to diabetes self-management.