Current Issues on Type 1 Diabetes Mellitus in Japanese Children

Abstract

Childhood-onset type 1 diabetes (T1D) is a relatively rare disease in Japan. In our department, we have around 50 patients with T1D. The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes (JSGIT) was established in 1994. Here, I will introduce the current issues surrounding T1D in the form of answers to eight questions.

T1D is classified into T1A (autoimmune) and T1B (idiopathic). T1A is an autoimmune disease in which pancreatic β cells are destroyed by both genetic and environmental factors. Associations with HLA and other gene polymorphisms (SNP) have been reported. The incidence of childhood-onset T1D is reportedly increasing in Europe and the US, but not in Japan. Autoimmune thyroid disease has been shown to accompany T1D frequently. Insulin pump therapy (CSII) is useful and has recently become popular for the treatment of younger children. A carbohydrate counting (Carbocount) is recommended by international medical practice guide lines for T1D. A smooth transition of medical care is required from pediatric clinics to adult clinics. The goals of treatment for T1D are normal growth and development and self-reliance as an adult. For these goals to be reached, social and psychological support is needed.