Early onset of diabetic nephropathy in a child with type 1 diabetes mellitus

An 11-year-old prepubertal girl with a history of metabolically poorly controlled type 1 diabetes for six years was diagnosed with diabetic nephropathy based on persistent overt proteinuria, hypertension, and renal biopsy findings typical of diabetic nephropathy. This case illustrates that diabetic nephropathy can develop even before puberty when metabolic control of the disease is not sufficient.     

Hyperthyroidism in juvenile diabetes mellitus.

Three cases of hyperthyroidism occurring in juvenile patients with diabetes mellitus are presented. The presence of hyperthyroidism should be suspected in patients with diabetes mellitus when goiters develop and when there is unexplained weight loss, tachycardia, tremors, unexplained increases in insulin requirement, or instability of the diabetes with a tendency toward development of ketosis and/or ketoacidosis.