Type 1 diabetes mellitus in children

Abstract

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.

Complications and manifestations of diabetic patients skin in Aden-Yemen

“…Uncontrolled diabetes increases the risk of development of microangiopathy and related complications or sequelae. Our study showed that a higher percentage (64.0%) of patients with cutaneous manifestation had systemic complications, like peripheral neuropathy, hypertension, retinopathy, nephropathy, coronary artery disease and cerebrovascular disease ,as was reported by Shemeret et al [26] , Bhat et al [4] and Mahajan et al [6] 55.5%, 87%, 89% respectively. Neuropathy was the most common complications (35.0%) documented in our study.…”

“…The complications of diabetes mellitus are many and inter-related and are mostly a result of poor glycemic control, hypertension, hyperlipidemia, obesity, and smoking [11] . There has been no significant statistical association between diabetic dermoangiopathy and diabetic retinopathy, neuropathy, nephropathy, or hypertension (P>0.05) in our study and similar results have been obtained by Mahajan et al [6]. In our study, type II DM has been associated with increased risk of diabetic complications, compared to type 1 DM, although the increased frequency had not achieved statistical significance.…”

“…So, the exact data of prevalence of skin changes among the diabetic patients is difficult to obtain. Various studies reported 7.6% to 30% of diabetics have some cutaneous involvement [ 24,6,25] study carried out by Yosipovitch et al found the prevalence of skin manifestations among Type 1 DM population as high as 71% [ 30 ].…”