[Initial status of the medical management of pediatric and adolescent type I diabetic patients].

Based upon a large number of type I diabetics, representative of diabetes in childhood and adolescence of the GDR and taking into consideration communication in the literature, the present position is commented on autoimmune pathogenesis, immune intervention, frequency of complications, optimizing of therapy and on social-medical aspects of the diabetic child in school. Besides first degree diabetes heredity, degree of HLA identity with the index case, disturbances of glucose tolerance and insulin secretion, auto-immunological phenomena directed against islet cells have to be considered without doubt as risk factors for diabetes. But absolutely reliable markers of an imminent diabetes onset do not exist. The frequency of somatic retardations and diabetes-specific complications is low under multiple insulin injection regime, used in 87 per cent. However, their occurrence alone should stimulate to remove existing differences between clinical achievable metabolic compensation (good: 60%; bad: 2.5%) and longterm metabolic control (good: 40%; bad: 22%). In order to realize this aim, medical care is orientated mainly on qualification of patients and their parents to self-adaption of the insulin dose regime in dependence on values of home-monitoring.