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Down Syndrome Abstract
of the Month: April 1998

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Type 1 diabetes mellitus and Down's syndrome: prevalence, management and diabetic complications

Anwar AJ, Walker JD, Frier BM
Diabet Med 1998 Feb;15(2):160-3

Department of Diabetes, Royal Infirmary of Edinburgh, NHS Trust, UK.

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Type 1 insulin-dependent, diabetes mellitus (Type 1 DM) is thought to be more prevalent in individuals with Down's syndrome. To ascertain the local prevalence of Type 1 DM in patients with Down's syndrome in a geographically defined area, the four diabetes clinics in Lothian were surveyed and 13 patients with Down's syndrome and Type 1 DM were identified. Using data from previous epidemiological surveys which determined the prevalence of Down's syndrome in the general population, the prevalence rate of Type 1 DM in patients with Down's syndrome was calculated to be between 1.4 and 10.6%, a prevalence considerably higher than in the general population. Although 7 (54%) of the Down's syndrome patients were treated with once daily administration of insulin, the mean HbA1c value of the group was similar to that observed in a control group of 39 age-, sex- and duration-matched Type 1 patients, all of whom were taking two or more injections of insulin daily. Glycemic control was therefore of similar quality to matched Type 1 patients without Down's syndrome, despite the frequent use of simple insulin regimens, which may relate to the more stable lifestyle of these patients.

My comments:

My comments: First, a reminder that diabetes mellitus is more common in children with DS. The warning signs are increased thirst, increased urination, fatigue and weight loss.

HbA1c is a blood test that measures how well "controlled" the blood sugar is in a diabetic. The fact that the HbA1c was similar in the DS and non-DS groups implies that management of the group with DS does not need to differ from the routine management of DM.

Other important items from the study: The ages of diagnosis ranged from 5 to 42 years of age. Complications of the DM included nephropathy, neuropathy and retinopathy. 5 of the 37 patients had coexisting hypothyroidism.
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