Studies on the natural history of asymptomatic diabetes in young people

Forty-five young patients with chemical diabetes have been followed for 1–16 yr. Among 21 of them aged 9–17 yr, 4 have developed insulin-dependent diabetes mellitus. None of the 24 aged 18–25 yr have decompensated. Delayed and subnormal insulin response to oral glucose was noted in those with chemical diabetes compared to normals, except for one nonobese patient who had hyperinsulinemia. Considerable fluctuation in glucose and/or insulin responses and their relationship was noted in repeated testing. These observations emphasize that validation of diagnostic criteria for glucose tolerance test interpretation need not depend on a high rate of progression to more severe hyperglycemia, and that the slow progression of latent diabetes permits consideration of prophylactic measures.