The definition of chemical diabetes in children

Data accumulated from the long-term study and followup of large numbers of siblings of overt diabetics in our clinic has established that there are at least three fairly distinct stages of diabetes in children: (1) Prediabetes—A state of genetic susceptibility in which there are no signs or symptoms of diabetes and all laboratory tests of carbohydrate tolerance are normal. (2) Chemical diabetes—A state of asymptomatic carbohydrate intolerance in which there are varying stages of severity that may be demonstrated and defined by the oral and intravenous glucose tolerance tests and serum insulin levels. (3) Overt diabetes —A state of symptomatic diabetes, which, in children, requires insulin therapy. Chemical diabetes may rapidly progress to overt diabetes, especially during the stresses of infections and growth. It may slowly progress over many years, remain stable without progression, or may, after the growth spurt, spontaneously regress to milder forms of carbohydrate intolerance or to the prediabetic state. The many factors responsible for this variability need intensive long-term study.