Adolescence is a vulnerable period for patients with diabetes. This regional survey demonstrated a marked decline in clinic attendance around the time of transition from paediatric to adult services. The reasons are complex, but mode of transfer may be an important factor.

The relation of epilepsy with gestation was studied in 59 patients through 153 pregnancies. In patients with idiopathic epilepsy, 45 per cent had more frequent fits during pregnancy, 50 per cent were unchanged, and 5 per cent were improved. The results in patients with symptomatic epilepsy were similar. Patients with a high frequency of fits in the pregestational state are likely to have an increased number when pregnant. Two cases of status epilepticus were treated successfully without interruption of pregnancy. Fourteen patients had true gestational epilepsy, 4 of whom had underlying organic disorders. Congenital heart disease occurred in 2 per cent and cleft lip or cleft lip and palate in 1 per cent of infants, all of these mothers on antiepileptic therapy. The rate was 4 and 10 times the rate in 69,000 consecutive births in the same area. Prompt control of repeated seizures during pregnancy is imperative, folic acid should be given , accumulation of water prevented, and patients who have their first fit during pregnancy should be investigated.

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