Local reactions to insulin injections are uncommon, when they do occur they are more likely to be due to sensitivity to the added preservatives (metacresol, phenol or methylhydroxybenzoate) than to the insulin. A trial of insulin with a different preservative may solve this problem. Formal identification of the preservative is possible using preservative-only preparations available from the manufacturers. Cold-sensitivity urticaria should also be considered if the patient develops a local reaction on using a vial directly from the refrigerator.

An oral glucose tolerance test (OGTT) is rarely indicated in making the diagnosis diabetes in childhood and adolescence. If doubt exists, it is easies to monitor the child or adolescent regularly with urine testing for glycosuria and to perform random blood tests to detect hyperglycaemia.

If the decision is made to proceed with diagnostic testing then an OGTT may be indicated if symptoms are present and a random venous plasma glucose concentration taken a least 2 hours after eating is 5.5 - 11.0 mmol/L and if in asymptomatic individuals the fasting venous plasma glucose is 5.5-7.7 mmol/L.

Bone is a type of connective tissue and like all tissues it is composed of cells actively engaged in physiologic pursuits. Some of these cells produce the rocklike bone substance, while others bring about the dissolution of this substance for the purpose of supplying calcium to the blood. Furthermore, certain cells in the red bone marrow manufacture blood corpuscles at a prodigious rate. It is estimated that about 1 million worn-out red blood corpuscles are destroyed every second, and quite obviously new ones must be produced to replace them. Failure of the red marrow to comply leads to anemia and, if nonreversible, ultimately to death. Finally, the skeletal system brackets all the other systems, and in so doing it serves as a logical introduction to the human body.

The skeletal system consists of bones and articulations. Articulation are the joints between the bones; bands of fibrous tissue, called ligaments, serve to support and strengthen joints. The system performs or is associated with five functions; support, protection, movement, calcium metabolism, and blood cell formation.

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