Sir.—Regarding the recent article by Buckingham et al,1 I would like to report our findings on the same subject.2-4
We investigated 55 insulin-dependent children and adolescents whose diabetes became clinically apparent before the age of 14 years. Their ages ranged from 5 to 18 years (mean [ ± SEM], 13.3 ± 5.1 years) and the duration of diabetes ranged from one to ten years (mean [±SEM], 4.5 ±2.6 years). Joint contractures were classified in three stages, according to Grgic et al,5 and respiratory function data were measured by constant whole-body plethysmography. Signs of retinal microangiopathy were evaluated by fluorescein angiography.
Limited joint mobility (LJM) was detected in 24 (43%) of 55 patients. Among children with a longer duration of diabetes (more than five years), 15 of 25 patients had LJM, and ten of these 15 patients also had retinal microangiopathy. Limited joint mobility, impaired respiratory function,
Madácsy L. Joint and Pulmonary Changes in Diabetes. Am J Dis Child. 1987;141(3):244–245. doi:10.1001/archpedi.1987.04460030022013
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