TYPE-1 DIABETES-MELLITUS AND DOWNS-SYNDROME - PREVALENCE, MANAGEMENT AND DIABETIC COMPLICATIONS

Type 1 insulin-dependent, diabetes mellitus (Type 1 DM) is thought to be more prevalent in individuals with Down's syndrome. To ascertain th e 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 iden tified. Using data from previous epidemiological surveys which determi ned the prevalence of Down's syndrome in the general population, the p revalence rate of Type 1 DM in patients with Down's syndrome was calcu lated to be between 1.4 and 10.6 %, a prevalence considerably higher t han in the general population. Although 7 (54 %) of the Down's syndrom e patients were treated with once daily administration of insulin, the mean HbA(1c) value of the group was similar to that observed in a con trol group of 39 age-, sex- and duration-matched Type 1 patients, all of whom were taking two or more injections of insulin daily. Glycaemic control was therefore of similar quality to matched Type 1 patients w ithout Down's syndrome, despite the frequent use of simple insulin reg imens, which may relate to the more stable lifestyle of these patients . (C) 1998 John Wiley & Sons, Ltd.