Sažetak. Šećerna bolest tipa 1 (ŠB) najčešća je endokrinološka bolest dječje dobi. Karakterizirana je deficitom inzulina koji nastaje zbog autoimunog uništenja β stanica gušterače. Javlja se u genetski predisponiranih osoba, a može biti potaknuta provocirajućim čimbenicima iz okoliša. Incidencija ŠB-a tipa 1 u djece je u porastu, u prvom redu u djece mlađe od 5 godina. Znakovi i simptomi bolesti razvijaju se brzo, obično u periodu kroz nekoliko tjedana. Tipični simptomi su poliurija, polidipsija, polifagija i gubitak na tjelesnoj težini. U nekih pacijenata inicijalni simptom početka ŠB-a tipa 1 je dijabetička ketoacidoza, po život opasno metaboličko stanje. Liječenje ŠB-a tipa 1 tijekom djetinjstva i adolescencije je kompleksno je i zahtjevno. Osnova liječenja pacijenata sa ŠB-om tipa 1 je inzulin. Postoji više različitih pripravaka inzulina i načina aplikacije inzulina. Intenzivirana terapija inzulinom u usporedbi s konvencionalnom terapijom poboljšava kontrolu glikemije i smanjuje dugoročne komplikacije ŠB-a. Važna komponenta u liječenju djece sa ŠB-om tipa 1 je pravilna prehrana. Glavni terapijski cilj je dobra kontrola glikemije (glikolizirani hemoglobin < 7,5 %) kako bi se spriječile kratkoročne i dugoročne komplikacije bolesti. Najčešće komplikacije bolesti u djece su hipoglikemija, hiperglikemija i dijabetička ketoacidoza.Ključne riječi: djeca; inzulin; liječenje; šećerna bolest tipa 1 Abstract. Type 1 diabetes mellitus is the most common chronic endocrine disease worldwide in children. It is characterised by autoimmune destruction of the β cells leading to insulin deficiency. This process occurs in genetically susceptible persons, and is probably triggered by one or more environmental factors. The incidence of type 1 diabetes mellitus is rising, especially in young children (age < 5 years). The signs and symptoms of disease in children usually develop quickly, over a period of a few weeks. Typical symptoms include polyuria, polydipsia and weight loss. In some patients diabetic ketoacidosis, a life-threatening metabolic state, can be the initial presentation of type 1 diabetes mellitus. Diabetes management is complex and challenging, particularly during childhood and adolescence. Insulin therapy is the mainstay in management of type 1 diabetes mellitus. There are many different insulin preparations and delivery systems available. Intensive insulin therapy compared with conventional therapy improves glycemic control and decreases long-term complications of diabetes. Another important issue in the management of children with type 1 diabetes mellitus includes nutrition. The main therapeuthic goal is good glycemic control of the disease (glycated haemoglobin <7,5 %) in order to prevent short and long term diabetic complications. The most common complications of type 1 diabetes mellitus in children include hypoglycemia, hyperglycemia and diabetic ketoacidosis.
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