CARE OF CHILDREN AND ADOLESCENTS WITH TYPE-I DIABETES-MELLITUS - DEMANDS AND REALITY

Annually around 1500 children and adolescents in Germany acquire type I diabetes mellitus. The longterm care of these patients and their families requires a competent multidisciplinary approach encompassing medical treatment, continued specific education and adequate psychosocial support, in order to promote their normal maturation, normal professional and private lives, and to minimize the shortterm and longterm hazards of their metabolic disorder. Due to the still rather low frequency of the disease in this country such a competence cannot be aquired in private practices, which constitute the backbone of the individualized health care system in the Federal Republic, thus prohibiting an adequate care for many of those affected. According to the WHO St. Vincent Declaration of 1989, which was signed also by the Federal Republic of Germany, therefore, the organization of treatment and care of children and adolescents with diabetes in specialized centres is mandatory and seems to provide a realistic chance to reduce the potentially life-threatening and invalidating neurovascular complications of this disease. This article is meant to stimulate a broader discussion among pediatricians about ways to an better care for children with diabetes.