RISK-FACTORS FOR EXPRESSION AND PROGRESSION OF LIMITED JOINT MOBILITYIN INSULIN-DEPENDENT CHILDHOOD DIABETES

We studied the prevalence of limited joint mobility (LJM) in 100 diabe tic children and 100 non-diabetic controls. Our objective was to find possible predictors for the expression and progression of LJM. and to evaluate the relationship between LJM and other long-term complication s of insulin-dependent diabetes mellitus. LJM was present in 36% of di abetic patients aged 2-20 years. It was significantly related to durat ion of disease and longitudinal glycated haemoglobin (HbA(1c)) concent rations, pubertal stage, number of ketoacidosis and skin changes. Four teen patients had peripheral neuropathy, 16 had microalbuminuria, 8 ha d nephropathy, and 7 had retinopathy. After matching for duration of d isease, HbA(1c) concentrations and pubertal stage, a comparison of the complication rates was made. All long-term complications were signifi cantly associated with LJM. Longer duration of disease and higher mean longitudinal glycated haemoglobin level are independent predictors fo r expression of LJM. Thus, improvement of metabolic control in diabeti c patients before puberty may diminish the expression and progression of LJM.