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,