KOMPLIKACIJE DIJABETES MELITUSA TIP 1 KOD DECE
Ključne reči:
dijabetes melitus tip 1, deca, komplikacije
Sažetak
Svetska Zdravstvena organizacija je definisala Dijabetes melitus kao poremećaj metabolizma različitih uzroka, zbog izostanka u sekreciji i/ili akciji insulina, sa dugotrajnim hiperglikemijama i izmenjenim metabolizmom šečera, belančevina i masti.
Dijabetes melitus je najrasprostranjenije hronično neinfektivno oboljenje, sa porastom učestalosti u dečijem uzrastu koje dostiže zabrinjavajuće razmere i zato se s pravom govori o epidemiji 21. veka. U svetu je incidencija u naglom porastu, dok se u poslednjih tridesetak godina u Srbiji zapaža porast broja obolelih izražen u grupi male i predškolske dece.
Izlaganje genetskim, imunološkim i faktorima životne sredine igra važnu ulogu u etiologiji bolesti, ali su osnovni mehanizmi ostali i dalje nepoznati.
Nedeljama pre postavljanja konačne dijagnoze najčešće se ispoljavaju malaksalost, slabost, neodoljiva glad, mršavljenje, pojačan osećaj žeđi, izražena diureza, sušenje sluznica, pruritus kože, zamagljen vid.
Neodgovarajuća glikemijska kontrola i pogoršanje lipidnog statusa dece obolele od dijabetesa tip 1 povezani su su sa brojnim komplikacijama i većim rizikom od kardiovaskularnih, perifernih vaskularnih i cerebrovaskularnih oboljenja.
U terapiji diajbetesa koristi se kombinacija insulinske terapije, adekvatne svakodnevne fizičke aktivnosti, raznovrsnosti ishrane, prevazilaženje stresnih životnih situacija i održavanje zadovoljavajuće metaboličke kontrole. Korišćenjem intenzivne insulinske terapije postiže se najbolja kontrola bolesti uz smanjenje učestalosti mogućih komplikacija.
Reference
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3. Chiang JL, Maahs DM, Garvey KC, Hood KK, Laffel LM, Weinzimer SA, et al.Type 1 Diabetes in Children and Adolescents: A Position Statement by the American Diabetes AssociationDiabetes Care. 2018 Sep;41(9):2026-2044. doi: 10.2337/dci18-0023. Epub 2018 Aug 9. PMID:30093549
4. Republička i stručna komisija za izradu i implementaciju vodiča dobre kliničke prakse. Nacionalni vodič dobre kliničke prakse za dijagnostiku i lečenje diabetes mellitusa. Drugo izmenjeno i dopunjeno izdanje, novembar 2012. Beograd: Ministarstvo zdravlja Republike Srbije. Dostupno na sajtu: https://www.zdravlje.gov.rs/view_file.php?file_id=656&cache=sr [Posećeno 3. Avgusta 2020].
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8. Feltbower RG, Bodansky HJ, Patterson CC, et al. Acute complications and drug misuse are important causes of death for children and young adults with type 1 diabetes: results from the Yorkshire Register of diabetes in children and young adults. Diabetes Care. 2008;31(5):922-926. doi:10.2337/dc07-2029
9. Karges B, Kapellen T, Wagner VM, et al. Glycated hemoglobin A1c as a risk factor for severe hypoglycemia in pediatric type 1 diabetes. Pediatr Diabetes. 2017;18(1):51-58. doi:10.1111/pedi.12348
10. Karges B, Rosenbauer J, Holterhus PM, et al. Hospital admission for diabetic ketoacidosis or severe hypoglycemia in 31,330 young patients with type 1 diabetes. Eur J Endocrinol. 2015;173(3):341-350. doi:10.1530/EJE-15-0129
11. Cho YH, Craig ME, Donaghue KC. Puberty as an accelerator for diabetes complications. Pediatr Diabetes. 2014;15(1):18-26. doi:10.1111/pedi.12112
12. Jenkins A, Januszewski A, O'Neal D. The early detection of atherosclerosis in type 1 diabetes: why, how and what to do about it. Cardiovasc Endocrinol Metab. 2019;8(1):14–27. Published 2019 Feb 13. doi:10.1097/XCE.0000000000000169
13. Groop PH, Thomas MC, Moran JL, et al. The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes. Diabetes. 2009;58(7):1651-1658. doi:10.2337/db08-1543
14. Huo L, Shaw JE, Wong E, Harding JL, Peeters A, Magliano DJ. Burden of diabetes in Australia: life expectancy and disability-free life expectancy in adults with diabetes. Diabetologia. 2016;59(7):1437-1445. doi:10.1007/s00125-016-3948-x
15. Cho YH, Craig ME, Hing S, et al. Microvascular complications assessment in adolescents with 2- to 5-yr duration of type 1 diabetes from 1990 to 2006 [published correction appears in Pediatr Diabetes. 2012 Feb;13(1):135]. Pediatr Diabetes. 2011;12(8):682-689. doi:10.1111/j.1399-5448.2011.00762.x
16. Diabetes Control and Complications Trial Research Group, Nathan DM, Genuth S, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329(14):977-986. doi:10.1056/NEJM199309303291401.
17. Chillarón JJ, Flores Le-Roux JA, Benaiges D, Pedro-Botet J. Type 1 diabetes, metabolic syndrome and cardiovascular risk. Metabolism. 2014;63(2):181-187. doi:10.1016/j.metabol.2013.10.002
18. Purnell JQ, Zinman B, Brunzell JD; DCCT/EDIC Research Group. The effect of excess weight gain with intensive diabetes mellitus treatment on cardiovascular disease risk factors and atherosclerosis in type 1 diabetes mellitus: results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC) study. Circulation. 2013;127(2):180‐187. doi:10.1161/CIRCULATIONAHA.111.077487
19. Šimonienė D, Platūkiene A, Prakapienė E, Radzevičienė L, Veličkiene D. Insulin Resistance in Type 1 Diabetes Mellitus and Its Association with Patient's Micro- and Macrovascular Complications, Sex Hormones, and Other Clinical Data. Diabetes Ther. 2020;11(1):161‐174. doi:10.1007/s13300-019-00729-5
20. Stankute I, Dobrovolskiene R, Danyte E, et al. Factors Affecting Cardiovascular Risk in Children, Adolescents, and Young Adults with Type 1 Diabetes. J Diabetes Res. 2019;2019:9134280. Published 2019 May 16. doi:10.1155/2019/9134280
21. Homma TK, Endo CM, Saruhashi T, Mori API, de Noronha RM, Monte O. et al. Dyslipidemia in young patients with type 1 diabetes mellitus. Arch Endocrinol Metab. 2015 Jun; 59(3): 215–219. doi: 10.1590/2359-3997000000040
22. Parthasarathy L, Chiplonkar S, Khadilkar V, Khadilkar A. Association Between Metabolic Control and Lipid Parameters in Indian Children with Type 1 Diabetes. Indian Pediatr. 2016;53(1):39-41. doi:10.1007/s13312-016-0787-2
23. El Bakry MM, Mansour AI, Ahmed ME, Sptan HE. Dyslipidemia in Egyptian children and adolescents with type 1 diabetes mellitus. Benha Med J 2017;34:104-7.
24. Salem M, Moneir I, Adly AM, Esmat K. Study of coronary artery calcification risk in Egyptian adolescents with type-1 diabetes. Acta Diabetol. 2011;48(1):41-53. doi:10.1007/s00592-010-0214-4
25. Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomark Insights. 2016;11:95-104. Published 2016 Jul 3. doi:10.4137/BMI.S38440
26. Beraki Å, Magnuson A, Särnblad S, Åman J, Samuelsson U. Increase in physical activity is associated with lower HbA1c levels in children and adolescents with type 1 diabetes: results from a cross-sectional study based on the Swedish pediatric diabetes quality registry (SWEDIABKIDS). Diabetes Res Clin Pract. 2014;105(1):119-125. doi:10.1016/j.diabres.2014.01.029
27. DuBose SN, Hermann JM, Tamborlane WV, et al. Obesity in Youth with Type 1 Diabetes in Germany, Austria, and the United States. J Pediatr. 2015;167(3):627-32.e324. doi:10.1016/j.jpeds.2015.05.046.
28. Gourgari E, Dabelea D, Rother K. Modifiable Risk Factors for Cardiovascular Disease in Children with Type 1 Diabetes: Can Early Intervention Prevent Future Cardiovascular Events?. Curr Diab Rep. 2017;17(12):134. Published 2017 Nov 3. doi:10.1007/s11892-017-0968-y
29. Tonoli C, Heyman E, Roelands B, et al. Type 1 diabetes-associated cognitive decline: a meta-analysis and update of the current literature. J Diabetes. 2014;6(6):499-513. doi:10.1111/1753-0407.12193
30. Seaquist ER. The Impact of Diabetes on Cerebral Structure and Function. Psychosom Med. 2015;77(6):616-621. doi:10.1097/PSY.0000000000000207
2. Alemzadeh R, Ali O. Diabetes mellitus in children. In: Kliegman R, Stanton B, Geme JS, Schor NF, editors. Nelson textbook of Pediatrics, 20th ed. Philadelphia, PA: Elsevier; 2016. p. 2163-2180.
3. Chiang JL, Maahs DM, Garvey KC, Hood KK, Laffel LM, Weinzimer SA, et al.Type 1 Diabetes in Children and Adolescents: A Position Statement by the American Diabetes AssociationDiabetes Care. 2018 Sep;41(9):2026-2044. doi: 10.2337/dci18-0023. Epub 2018 Aug 9. PMID:30093549
4. Republička i stručna komisija za izradu i implementaciju vodiča dobre kliničke prakse. Nacionalni vodič dobre kliničke prakse za dijagnostiku i lečenje diabetes mellitusa. Drugo izmenjeno i dopunjeno izdanje, novembar 2012. Beograd: Ministarstvo zdravlja Republike Srbije. Dostupno na sajtu: https://www.zdravlje.gov.rs/view_file.php?file_id=656&cache=sr [Posećeno 3. Avgusta 2020].
5. Rakočević I, Miljuš D, Božić Z. Incidencija i mortalitet od dijabetesa u Srbiji 2018. Registar za dijabetes u Srbiji, izveštaj br.13, Beograd: Institut za javno zdravlje Srbije „Milan Jovanović Batut“; 2018. Dostupno na sajtu: http://www.batut.org.rs/download/publikacije/2018IzvestajDijabetes.pdf [Posećeno 3. Avgusta 2020].
6. American Diabetes Association. Standards of Medical Care in Diabetes-2017 Abridged for Primary Care Providers. Clin Diabetes. 2017;35(1):5-26. doi:10.2337/cd16-0067
7. Cameron FJ, Wherrett DK. Care of diabetes in children and adolescents: controversies, changes, and consensus. Lancet. 2015;385(9982):2096-2106. doi:10.1016/S0140-6736(15)60971-0
8. Feltbower RG, Bodansky HJ, Patterson CC, et al. Acute complications and drug misuse are important causes of death for children and young adults with type 1 diabetes: results from the Yorkshire Register of diabetes in children and young adults. Diabetes Care. 2008;31(5):922-926. doi:10.2337/dc07-2029
9. Karges B, Kapellen T, Wagner VM, et al. Glycated hemoglobin A1c as a risk factor for severe hypoglycemia in pediatric type 1 diabetes. Pediatr Diabetes. 2017;18(1):51-58. doi:10.1111/pedi.12348
10. Karges B, Rosenbauer J, Holterhus PM, et al. Hospital admission for diabetic ketoacidosis or severe hypoglycemia in 31,330 young patients with type 1 diabetes. Eur J Endocrinol. 2015;173(3):341-350. doi:10.1530/EJE-15-0129
11. Cho YH, Craig ME, Donaghue KC. Puberty as an accelerator for diabetes complications. Pediatr Diabetes. 2014;15(1):18-26. doi:10.1111/pedi.12112
12. Jenkins A, Januszewski A, O'Neal D. The early detection of atherosclerosis in type 1 diabetes: why, how and what to do about it. Cardiovasc Endocrinol Metab. 2019;8(1):14–27. Published 2019 Feb 13. doi:10.1097/XCE.0000000000000169
13. Groop PH, Thomas MC, Moran JL, et al. The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes. Diabetes. 2009;58(7):1651-1658. doi:10.2337/db08-1543
14. Huo L, Shaw JE, Wong E, Harding JL, Peeters A, Magliano DJ. Burden of diabetes in Australia: life expectancy and disability-free life expectancy in adults with diabetes. Diabetologia. 2016;59(7):1437-1445. doi:10.1007/s00125-016-3948-x
15. Cho YH, Craig ME, Hing S, et al. Microvascular complications assessment in adolescents with 2- to 5-yr duration of type 1 diabetes from 1990 to 2006 [published correction appears in Pediatr Diabetes. 2012 Feb;13(1):135]. Pediatr Diabetes. 2011;12(8):682-689. doi:10.1111/j.1399-5448.2011.00762.x
16. Diabetes Control and Complications Trial Research Group, Nathan DM, Genuth S, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329(14):977-986. doi:10.1056/NEJM199309303291401.
17. Chillarón JJ, Flores Le-Roux JA, Benaiges D, Pedro-Botet J. Type 1 diabetes, metabolic syndrome and cardiovascular risk. Metabolism. 2014;63(2):181-187. doi:10.1016/j.metabol.2013.10.002
18. Purnell JQ, Zinman B, Brunzell JD; DCCT/EDIC Research Group. The effect of excess weight gain with intensive diabetes mellitus treatment on cardiovascular disease risk factors and atherosclerosis in type 1 diabetes mellitus: results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC) study. Circulation. 2013;127(2):180‐187. doi:10.1161/CIRCULATIONAHA.111.077487
19. Šimonienė D, Platūkiene A, Prakapienė E, Radzevičienė L, Veličkiene D. Insulin Resistance in Type 1 Diabetes Mellitus and Its Association with Patient's Micro- and Macrovascular Complications, Sex Hormones, and Other Clinical Data. Diabetes Ther. 2020;11(1):161‐174. doi:10.1007/s13300-019-00729-5
20. Stankute I, Dobrovolskiene R, Danyte E, et al. Factors Affecting Cardiovascular Risk in Children, Adolescents, and Young Adults with Type 1 Diabetes. J Diabetes Res. 2019;2019:9134280. Published 2019 May 16. doi:10.1155/2019/9134280
21. Homma TK, Endo CM, Saruhashi T, Mori API, de Noronha RM, Monte O. et al. Dyslipidemia in young patients with type 1 diabetes mellitus. Arch Endocrinol Metab. 2015 Jun; 59(3): 215–219. doi: 10.1590/2359-3997000000040
22. Parthasarathy L, Chiplonkar S, Khadilkar V, Khadilkar A. Association Between Metabolic Control and Lipid Parameters in Indian Children with Type 1 Diabetes. Indian Pediatr. 2016;53(1):39-41. doi:10.1007/s13312-016-0787-2
23. El Bakry MM, Mansour AI, Ahmed ME, Sptan HE. Dyslipidemia in Egyptian children and adolescents with type 1 diabetes mellitus. Benha Med J 2017;34:104-7.
24. Salem M, Moneir I, Adly AM, Esmat K. Study of coronary artery calcification risk in Egyptian adolescents with type-1 diabetes. Acta Diabetol. 2011;48(1):41-53. doi:10.1007/s00592-010-0214-4
25. Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomark Insights. 2016;11:95-104. Published 2016 Jul 3. doi:10.4137/BMI.S38440
26. Beraki Å, Magnuson A, Särnblad S, Åman J, Samuelsson U. Increase in physical activity is associated with lower HbA1c levels in children and adolescents with type 1 diabetes: results from a cross-sectional study based on the Swedish pediatric diabetes quality registry (SWEDIABKIDS). Diabetes Res Clin Pract. 2014;105(1):119-125. doi:10.1016/j.diabres.2014.01.029
27. DuBose SN, Hermann JM, Tamborlane WV, et al. Obesity in Youth with Type 1 Diabetes in Germany, Austria, and the United States. J Pediatr. 2015;167(3):627-32.e324. doi:10.1016/j.jpeds.2015.05.046.
28. Gourgari E, Dabelea D, Rother K. Modifiable Risk Factors for Cardiovascular Disease in Children with Type 1 Diabetes: Can Early Intervention Prevent Future Cardiovascular Events?. Curr Diab Rep. 2017;17(12):134. Published 2017 Nov 3. doi:10.1007/s11892-017-0968-y
29. Tonoli C, Heyman E, Roelands B, et al. Type 1 diabetes-associated cognitive decline: a meta-analysis and update of the current literature. J Diabetes. 2014;6(6):499-513. doi:10.1111/1753-0407.12193
30. Seaquist ER. The Impact of Diabetes on Cerebral Structure and Function. Psychosom Med. 2015;77(6):616-621. doi:10.1097/PSY.0000000000000207
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2020/09/15
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