الفهرس 
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Abstract
Diabete~ mellitus in childhood ~6 considered the moat endocrine-~t~bolic disQrder that has important consequence~ on physical and amotional development re6ult~nq in serious compl~cations in adulthood. It is due to de~iciency Qf ln~u1ln or its action.
CLASSI~ICATIONS OF DIABETES:
1. Insulin d~pandent diabetes ~ellitU6 or juvenile di”,betBs in which ketosi.\l prone diabetes and brittle diabetes. The on5eti~~ypically in childhood and youth, but It can ba at any age.
2. Non insulin dependent diabetes mellitus or
maturity on$~t diabetes.
3. Other types include diabetes associated
wi th certain conditions and’ syndtro_s as genetic syndromeB, drugs or chemical ~uced diabetes and di~eteB resulting after pancreatectomy ~or hyperqlyce~ia.
The exact. incidence of insulin depandent diabete~ mellitu5 in Egypt is nat known but it is eetimated to be about l in 1000 childr~n (Gabr and Abdel-Salam, 1962). Insulin dependent diabete~ mellitus is considered to be due to genetic &nd e~vironmental factors. In addition, recently oiagnQsed insulin dependent diabetics have mononuclear 1nfl~tory cells
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permeating and surrounding their islet cells and islet cell antibodies. This insu11t15 may be due to eithe destruction of islet cells or by an auto1mPune re~ctlon. both could bli! ca\1$ed by an enviroIUlltilltal. a.gent aoting in ~ genetically ~~Bceptible hoat. The environmental agents are viruses and tOX~5. Vi[us~s may damage tne pancreas either genera~+y a~ with mumpB, pancreatit~$ cr specifically by damaging the !slets as by to~in~.
PA~BOLOGY OF DIABETES MELLITUS:
Pathology of diabetes melH.tus including
Changes i~ the pancreas and ch~nqee iD extrapancreatic structures.-c Abnormall~ elevated concentration of glucose may of itself lead to the vascuar and tissue changes.
The noo~enzy.matic gl.ycosylation of ~-increaged proportion of long-lived prote~5 that occurs with an i~crease in” glucose concentration can impa~r their functiuo. Haemoglobin Ls markedlll affect,.,d .in. this way, wi til an ~dve:rse effeo.t on it5 d£in.!-ty for ox-yqelI-.
The cla55ic~:6ymptorns of lnsuLiD” dependent di~ete~ mellitus are polY\l.ria, polydipsia., lethargy and weight 106S. However, there is copsiderable variat~on in the way these SymptOIlLS present. cr.nd this has a g:re ••. t importtance for the ear~y diagnosis of thLs disease. Gradual Oll$et of juvenil~ diabetes i~ commoner than is often realized ~ the diagnosis i~ often delayed or missed.