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The Classification of Diabetes Mellitus in Children and Adolescents

There is increasing interest in the study of factors responsible for the development of diabetes mellitus in childhood. Research focus has been principally on genetic factors (primarily HLA antigen status) and autoimmune beta cell destructive mechanisms. There is considerable importance in broadening the scope of research into etiology and classification. Some of the issues that need to be resolved include: 1) What is the frequency of IDDM occurring in children and adolescents with diabetes? 2) Does the frequency of IDDM within the childhood diabetes population vary according to geographic, cultural and racial characteristics? 3) Are there genetic factors responsible for the expression of IDDM that are not HLA or Chromosome 6 related? 4) Is the mechanism of beta cell destruction in IDDM invariably due to autoimmune mechanisms? 5) Are there etiologically important environmental factors (infections, nutrition, stress, etc.) involved in the expression of childhood diabetes mellitus? 6) What is the frequency of Maturity Onset Diabetes in Youth (MODY) in childhood diabetes and does its frequency vary from culture to culture? 7) How is MODY related to IDDM and NIDDM in terms of genetics,