[The prognosis of insulin-dependent diabetes mellitus]

The prognosis of juvenile-dependent diabetics is characterized by an overmortality of 600 per cent. The quality of life is reduced, too, since about 15 per cent of the patients with a diabetes onset before the age of 31 will become blind, 10-15 per cent will become amputated on calf or thigh and 20-30 per cent will develop uraemia. A highly significant increased survival was seen in patients, who were controlled 4 to 5 times a year at the diabetic out-patient clinic. Death from ketoacidosis, hypoglycaemia, and suicide was significantly higher in the group not referred for out-patient control, and death by uraemia occurred earlier in this group. Juvenile diabetics with long-standing diabetes and persisting and endogenic insulin secretion had significantly less severe retinopathy and nephropathy than comparable patients without endogenous insulin secretion, and survival of juvenile diabetics with clinical indications of persisting endogenous insulin secretion seems not to be different from non-diabetics. It is concluded that more should be done to motivate patients for self-care and to preserve remaining insulin producing cells in insulin-dependent diabetics.