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In the study we examined children with type 1 diabetes, aged 8 to 17 years, divided into groups depending on the duration of the disease (up to 5 years and over 5 years) in order to study the electrocardiographic changes by daily Holter ECG monitoring depending on the duration of the disease, glycaemia and insulin therapy. Holter ECG monitoring was performed by ECG monitoring complex “DiaCard” ("SOLVAIG" JSC, Kyiv, Ukraine). During the monitoring, the subjects kept a diary of activity with a record of the symptoms, time and dose of insulin and other drugs, as well as indicators of glycaemia, time and quality of sleep. In addition to arrhythmias and conduction parameters, standard parameters of the whole ECG were determined, including ST segment analysis, as well as QT and QT corrected intervals and their dispersion. All ECG parameters per day were evaluated in comparison with the normative values of heart rate in healthy children according to sex and age. The results indicate that regardless of the duration of the disease, there are cardiac dysrhythmias, mainly associated with changes in the automatism of the sinus node and increased activity of ectopic foci of rhythm, which weakens the parasympathetic effects on the heart. Correlation analysis of the detected ECG changes in patients confirmed the progressive effect of the sympathetic part of the autonomic nervous system on heart rate, the relationship of glycaemia with repolarization of ventricles and heart rate, cardiac arrhythmias with changes in sleep structure and awakening according to heart rate. These data can be used to optimize the diagnosis of diabetic heart disease in children and to identify patients who need close attention from cardiologists.
In the study we examined children with type 1 diabetes, aged 8 to 17 years, divided into groups depending on the duration of the disease (up to 5 years and over 5 years) in order to study the electrocardiographic changes by daily Holter ECG monitoring depending on the duration of the disease, glycaemia and insulin therapy. Holter ECG monitoring was performed by ECG monitoring complex “DiaCard” ("SOLVAIG" JSC, Kyiv, Ukraine). During the monitoring, the subjects kept a diary of activity with a record of the symptoms, time and dose of insulin and other drugs, as well as indicators of glycaemia, time and quality of sleep. In addition to arrhythmias and conduction parameters, standard parameters of the whole ECG were determined, including ST segment analysis, as well as QT and QT corrected intervals and their dispersion. All ECG parameters per day were evaluated in comparison with the normative values of heart rate in healthy children according to sex and age. The results indicate that regardless of the duration of the disease, there are cardiac dysrhythmias, mainly associated with changes in the automatism of the sinus node and increased activity of ectopic foci of rhythm, which weakens the parasympathetic effects on the heart. Correlation analysis of the detected ECG changes in patients confirmed the progressive effect of the sympathetic part of the autonomic nervous system on heart rate, the relationship of glycaemia with repolarization of ventricles and heart rate, cardiac arrhythmias with changes in sleep structure and awakening according to heart rate. These data can be used to optimize the diagnosis of diabetic heart disease in children and to identify patients who need close attention from cardiologists.
Introduction: Worldwide, there is a tendency to an increase in the number of patients with diabetes mellitus. After cardiovascular disease and oncology, this disease takes the third place, being ahead of HIV and tuberculosis. The aim of the research was to study and analyze the dynamics of the prevalence, incidence and disability of diabetes mellitus among children aged 0-17 years in the Poltava region over the period of 2008-2017. Materials and methods: The data of statistical reports of medical institutions and the Center of Medical Statistics of the Ministry of Health of Ukraine over the period of 2008- 2017 was analyzed. The obtained data was processed using using the MS Office 2010 software package. Review: We have found that the prevalence of diabetes mellitus among children under the age of 17 in the Poltava region is constantly growing. In 2008, the prevalence of diabetes among children aged 0-17 years was 1.11. In 2017, the index was 1.32. Regarding the incidence, the indicator also gradually increased, in 2017 it was 0.21 versus 0.12 in 2008. Having analyzed the disability of diabetes among children, it is evident that the total disability is gradually increasing. If in 2008 there were 185children with diabetes mellitus, then in 2017 there were 256 people (disability index 0.72 and 1.09, respectively). The primary disability among children in 2017 was 0.19, in 2008 it was 0.09, respectively. Conclusions: The presented research allowed to study and analyze the incidence, prevalence and disability of diabetes mellitus among children from 0 to 17 years old in the Poltava region over the period of 2008-2017.
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