This proposal is a preliminary step towards improving the clinical outcome of insulin-dependent diabetes mellitus (IDDM) in minority Afro- American and Hispanic children and adolescents in Colorado. The present objective is to compare selective indicators of early complications of diabetes between minority juvenile IDDM subjects and age and disease duration matched Caucasian controls. The latter will be chosen from a pool of approximately 1200 juvenile IDDM subjects of Caucasian origin that are followed at two Pediatric Diabetes Clinics in Denver. If minorities receive less than adequate medical care for IDDM, they may be at risk of earlier development of renal and retinal microvascular complications.
The specific aims are firstly to establish a roster of juvenile IDDM minorities who are followed medically in the Denver metropolitan area. Thereafter, through chart review, weight for height z-scores or body mass indices, and the prevalence of blood pressures in excess of the 90th percentile for age among minorities will be compared to those of matched Caucasian IDDM controls. For minority participants in a specialized Eye-Kidney Clinic, urinary albumin excretion rates and retinal changes will be compared to those of appropriate Caucasian controls. In subjects with elevation of blood pressure, increased body mass indices or abnormal microalbumin excretion rates, dietary intakes of protein and sodium will be assessed for comparison to those of matched Caucasian IDDM subjects. Correlations between blood pressures, weight indices, microalbuminuria, and specific nutrient dietary intakes will be examined.
