Ao. Akanji, CLINICAL-EXPERIENCE WITH ADOLESCENT DIABETES IN A NIGERIAN TEACHING HOSPITAL, Journal of the National Medical Association, 88(2), 1996, pp. 101-105
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.