CLINICAL-EXPERIENCE WITH ADOLESCENT DIABETES IN A NIGERIAN TEACHING HOSPITAL

Diabetes mellitus presenting in adolescents age 10 to 20 years account s for less than 5% of all diabetes in tropical African countries, Cons equently, inadequate attention is paid to the medical and psychosocial problems attendant on adolescent diabetes in those countries, This ar ticle highlights our clinical experience in the management of 30 adole scent diabetic subjects who presented consecutively in the diabetic cl inic of a major Nigerian teaching hospital, In these patients, adolesc ent diabetes appeared heterogeneous, comprising classical insulin-depe ndent diabetes mellitus (IDDM) in approximately 80%; the remaining fra ction (20%) was contributed variably by malnutrition-related diabetes (MRDM) and an ''atypical'' form of IDDM,The most common medical compli cations were recurrent hypoglycemia, ketoacidosis, and infections, Abo ut 80% of the patients were poor, and up to two thirds had to withdraw from school or trade because of recurrent illness, One third of the g irls had a history of unwanted pregnancies, Almost all (93%) had a his tory of general rebelliousness and clinic truancy. Therefore, the high prevalence of acute metabolic decompensation may be related to the in creased frequency of psychosocial problems, especially poverty, in the se patients, It is suggested that agencies in tropical Africa increase welfare facilities for adolescent chronic disease, and also establish and encourage clinics dedicated to adolescent diabetes care.