Non-insulin dependent diabetes (NIDDM) was diagnosed in 188 of more than 7 million Tokyo schoolchildren tested between 1974 and 1994 for glycosuria followed by oral glucose tolerance testing. The incidence rate of NIDDM in youth has continued to increase since 1976. While the daily energy intake has not changed significantly, the consumption of animal protein and fat by the Japanese population has greatly increased during the past two decades, and this change in diet, with low levels of physical activity, may exacerbate insulin resistance and glucose intolerance.

The School Health Law of Japan was passed in 1974 mandating urine screening of elementary and junior high-school students for the detection of renal disease. A first morning urine was obtained on an annual basis for each individual student for the time period 1974-1986. The prevalence of proteinuria and haematuria among elementary school children was 0.08% and 0.54%, respectively, while junior high-school students demonstrated corresponding prevalences of 0.37% and 0.94%. The theoretical merits of this screening programme include the detection of glomerulonephritis with possible early therapeutic intervention. However, a limitation to this approach is its over-sensitivity where asymptomatic urine abnormalities is found to be 10 times greater in frequency than glomerulonephritis histologically.

No abstract

This new criteria should prove valuable in health strategies for rational prevention and intervention in children. It should be emphasized to provide some intervention for Japanese children immediately.