normality of insulin reaction apparently mediates the basic metabolic disturbance that occurs. The sugar, which cannot be properly utilized by the body, collects in the blood and may be subsequently excreted in the urine. In addition, a functional alteration of the vascular system, including both the large and small blood vessels, inevitably occurs (U.S. News and World Report 74) . DEFINITION OF TYPE 1 DIABETES Diabetes is usually classified as either growth onset diabetes (type 1 or juvenile) or adult diabetes (type2). Type 1 diabetes almost always appears explosively in persons under 20 years of age and is recognized because the patient becomes acutely ill. The juvenile diabetic’s condition is labile, and both acidosis and hypoglycemia are likely to occur. This is sometimes called “brittle” diabetes. Insulin is required, but even with this, the disease may not be stable (Public Health Service Publication 1). Insulin-dependent diabetes (Type I), also called juvenile-onset diabetes, is the more serious form of the disease; about 10% of diabetics have this form. It is caused by destruction of pancreatic cells that make insulin and usually develops before age 30. Type I diabetics have a genetic predisposition to the disease. There is some evidence that it is triggered by a virus that changes the pancreatic cells in a way that prompts the immune system to attack them. The symptoms are the same as in the non-insulin-dependent variant, but they develop more rapidly and with more severity. Treatment includes a diet limited in carbohydrates and saturated fat, exercise to burn glucose, and regular insulin injections, sometimes administered via a portable insulin pump (Public Health Service Publication 2). SCOPE OF PROBLEM Diabetes is a worldwide disease and one of the most common endocrine disorders in the United States. Estimates vary, but there are more than 16 million diabetes in this country and nearly one million have type 1 diabetes (U.S. News and World Report 74). The number of diabetics seems to be increasing, and there are a number of reasons for this. First, people, in general, are living longer. Also, the life expectancy of diabetics is increasing; consequently, the total number of diabetics is on the increase. Young diabetics now remain alive and are able to bear children, thus increasing the number of people with inherited tendency toward the Type 1 diabetes. Type 1 Diabetes is most likely to be found among those who are: 1) at a young age, 2) obese, 3) blood relatives of diabetics, 4) mothers who have given birth to babies that weighed 9 pounds or more at birth, and 5) women who have shown carbohydrate intolerance during pregnancy. Also the National Health Interview Survey data indicate that rates of diagnosed diabetes are higher in low-income groups and among persons with fewer years of education (Public Health Service Publication 5). There is also a connection between blacks and diabetes but in Type 1 the results aren’t positive yet. DETECTION Diabetes screening refers to the application of blood and/or urine tests preferably after a glucose challenge to large numbers of persons in the general population, or better yet, to selected high-risk groups. Blood tests are more sensitive and specific than urine tests and are more likely to identify the diabetics in the population studied. Formerly, a urine test for sugar was accepted as an adequate screening procedure. Today, it is recognized that sugar is not always present in the urine of a person who has diabetes, and that a person without diabetes may have sugar in the urine. Also, by the time sug

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