Елементи метаболичке контроле код деце оболеле од дијабетеса тип 1 пре и после увођења инсулинских аналога у лечење

Abstract

Introduction Diabetes mellitus type 1 (T1DM) in children is characterized by unstable course. A significant number of studies shows that introduction to insulin analogues treatment aims towards better control of the disease.

Objective The assessment of metabolic control in children with T1DM that were introduced to insulin analogue treatment after many years of treatment with classic (human) insulin.

Methods The study included 59 patients 2-19 years old (12.9±3.8) with T1DM, transferred from treatment with human insulin to insulin analogues treatment. Data were obtained directly from patients and their parents, as well as from medical records.

Results The introduction to insulin analogues treatment, leads to a decrease in the value of glycolized haemoglobin (HbA1c) after 6 months (9.27±1.68% vs 8.63±1:26%, p=0.06). Average daily dose of insulin expressed per IU/kg of classic and insulin analogue (1.04±0.38 vs 1.03±0.30; p>0.05), remained almost the same. In 39 examinees (66.1%), 6 months before the introduction to insulin analogue treatment, severe hypoglicemia was registered and 6 months after the introduction to insulin analogue treatment it appeared in only two examinees (3.4%) (p<0.001). Ketoacidosis, 6 months before introduction to insulin analogues treatment, appeared in 16 examinees (27.1%), while 6 months after it was not registered (p<0.001).

Conclusion The use of insulin analogue treatment in childhood provides adequate metabolic control and substantially reduces the risk of acute complications (severe hypoglicemia, ketoacidosis).

Keywords: diabetes mellitus type 1; insulin analogues; metabolic control; puberty