title: Diabetes mellitus in childhood: an emerging condition in the 21st century.
abstract: The International Diabetes Federation (IDF-2015) estimates the existence of 30,900 children under 15 years old with type 1 diabetes mellitus (DM1) in Brazil, and an increase of 3.0% per year is expected. This review focused on meta-analysis and pediatric diabetes update articles in order to draw attention to the need of planning coping strategies to support this serious public health problem in coming years. DM1 is considered an immuno-mediated disease with a complex transmission influenced by genetic and environmental factors responsible for a gradual destruction of the insulin producing pancreatic beta cells. Seroconversion to DM1-associated autoantibodies and abnormalities in metabolic tests that assess insulin secretion and glucose tolerance can be used as predictive criteria of beta cells functional reserve and the onset of the clinical disease. Symptomatic DM1 treatment is complex and the maintenance of good metabolic control is still the only effective strategy for preserving beta cell function. Disease duration and hyperglycemia are both risk factors for the onset of chronic vascular complications that negatively affect the quality of life and survival of these patients. In this regard, health teams must be trained to provide the best possible information on pediatric diabetes, through continuing education programs focused on enabling these young people and their families to diabetes self-management.
authors.affiliation: PhD in Sciences from Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
authors.forename: Thais
authors.initials: T
authors.lastname: Della Manna
authors.affiliation: Associate Professor, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Nuvarte
authors.initials: N
authors.lastname: Setian
authors.affiliation: PhD Student, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Roberta Diaz
authors.initials: RD
authors.lastname: Savoldelli
authors.affiliation: PhD in Sciences from FMUSP, São Paulo, SP, Brazil.
authors.forename: Dulce Rondina
authors.initials: DR
authors.lastname: Guedes
authors.affiliation: PhD in Sciences from FMUSP, São Paulo, SP, Brazil.
authors.forename: Hilton
authors.initials: H
authors.lastname: Kuperman
authors.affiliation: MSc in Medicine from FMUSP, São Paulo, SP, Brazil.
authors.forename: Hamilton Cabral
authors.initials: HC
authors.lastname: Menezes
authors.affiliation: MSc from FMUSP, São Paulo, SP, Brazil.
authors.forename: Leandra
authors.initials: L
authors.lastname: Steinmetz
authors.affiliation: MSc from FMUSP, São Paulo, SP, Brazil.
authors.forename: Louise
authors.initials: L
authors.lastname: Cominato
authors.affiliation: PhD in Pediatrics from FMUSP, São Paulo, SP, Brazil.
authors.forename: Vaê
authors.initials: V
authors.lastname: Dichtchekenian
authors.affiliation: Professor, Habilitation (BR: Livre-docência), Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Durval
authors.initials: D
authors.lastname: Damiani
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D012307:Risk Factors