All newly diagnosed diabetic patients in Sweden aged 15-34 years have been registered since 1983. In this study the clinical characteristics initially and after 2.5-3 years were evaluated by a questionnaire to the patient's physician and by non-fasting C-peptide. The study comprised patients registered 1983-84, and for 281 patients (37%), complete information was obtained. At diagnosis 75% were classified as Type 1, 19% as Type 2, and 6% as secondary diabetes or as uncertain by their physician. Twenty patients (7.1%) were reported to have ketoacidosis. Seventy-five percent were treated with insulin, 7% with oral hypoglycaemic agents (OHG), and 18% with diet alone. At follow-up 71% were classified as Type 1, 21% as Type 2, and 8% as secondary or uncertain while treatment was 82% insulin, 8% OHG, and 9% diet. During the follow-up period 42% of the initially non-insulin-treated patients were put on insulin whereas only a few stopped insulin treatment. Patients treated with diet or OHG at follow-up were older, had higher percent desirable weight, and lower blood glucose at diagnosis than patients treated with insulin. All except one patient had measurable random C-peptide at follow-up and mean values were for patients treated with insulin 0.55, OHG 1.41 and diet alone 1.29 nmol l-1. Random blood glucose results were similar. In conclusion the majority of newly diagnosed patients in the age group 15-34 years have the characteristics of Type 1 diabetes and Type 2 diabetes is rare before 25-30 years of age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

Insulin wastage in ambulant practice.

The total insulin consumption in 162 insulin-requiring diabetic patients was calculated from the prescriptions of purchased insulin for 1979-80. The mean daily consumption was 58.6 U, whereas the actual dose injected was 41.7 U. A mean of 1.9 doses was injected daily, which yields a loss per dose of 8.9 U (SD +/- 7.9). The dose loss was independent of age and sex and only marginally dependent on insulin dose. Visual impairment increased the loss. From a direct study of 101 patients while drawing their usual morning dose of insulin into the syringe, the following major factors underlying insulin wastage emerged: (1) expulsion of surplus insulin into the air instead of into the vial, when adjustment of the insulin dose is made; (2) use of syringes with a separate needle instead of new low-dead-space syringes; and (3) unnecessary use of 2-ml syringes for doses of insulin less than or equal to 40 U (less than or equal to 1 ml).

Adolescent↗

PubMedDate not supplied

Negative association between type 1 diabetes and HLA DQB10602-DQA10102 is attenuated with age at onset. Swedish Childhood Diabetes Study Group.

HLA-associated relative risks of type 1 (insulin-dependent) diabetes mellitus were analysed in population-based Swedish patients and controls aged 0-34 years. The age dependence of HLA-associated relative risks was assessed by likelihood ratio tests of regression parameters in separate logistic regression models for each HLA category. The analyses demonstrated an attenuation with increasing age at onset in the relative risk for the positively associated DQB1*0201-A1*0502/B1*0302-A1*0301 (DQ2/8) genotype (P = 0.02) and the negatively associated DQB1*0602-A1*0102 (DQ6.2) haplotype (P = 0.004). At birth, DQ6.2-positive individuals had an estimated relative risk of 0.03, but this increased to 1.1 at age 35 years. Relative risks for individuals with DQ genotype 8/8 or 8/X or DQ genotype 2/2 or 2/X, where X is any DQ haplotype other than 2, 8 or 6.2, were not significantly age-dependent. An exploratory analysis of DQ haplotypes other than 2, 8 and 6.2 suggested that the risk of type 1 diabetes increases with age for DQB1*0604-A1*0102 (DQ6.4) and that the peak risk for the negatively associated DQB1*0301-A1*0501 haplotype is at age 18 years. There was also weak evidence that the risk for DQB1*0303-A1*0301 (DQ9), which has a positive association in the Japanese population, may decrease with age. We speculate that HLA-DQ alleles have a significant effect on the rate of beta cell destruction, which is accelerated in DQ2/8-positive individuals and inhibited, but not completely blocked, in DQ6.2-positive individuals.

Adolescent↗

PubMedDate not supplied

Impaired glucose tolerance: influence by environmental and hereditary factors.

The influence on impaired glucose tolerance (IGT) by obesity, physical leisure time activity (PLTA), family histories of diabetes mellitus (DM) and other characteristics were evaluated in a health survey of 807 middle-aged females and males, with the rate of IGT 8.4% (WHO-criteria). Independent (adjusted for covariates) odds ratios concerning IGT were estimated. The ratios were 5.3 with the presence of obesity and 2.2. (ns) with low compared to high PLTA. In a subgroup of summarized environmental factors (obesity and low PLTA versus no obesity and high PLTA, n = 339), the independent odds ratio for IGT was 9.6 with obesity and low PLTA. With one 1st degree DM relative the odds ratio for IGT was 3.1. The ratio was increased both with the presence of relatives with non-insulin-dependent diabetes mellitus and with the presence of relatives with insulin-treated diabetes. Diabetic mothers yielded a higher ratio for IGT than diabetic fathers. In conclusion, the independent relative risk for IGT in this Swedish middle-aged urban sample was about two times higher with environmental factors (obesity only/obesity with low PLTA) than with one 1st degree DM relative.

Diabetes Mellitus, Type 1↗

PubMedDate not supplied

Aspects on the diagnosis of ureteric complications following renal transplantation.

Among 108 cadaveric renal transplantations serious complications from the ureter were found in 10%. Another nine cases showed abnormal urograms and scintigrams of doubtful significance. Some of these are discussed.

Humans↗