Tip 1 Diyabetes mellitus tanılı çocuklarda insülin tedavisi çeşitlerinin somatik büyümeye etkisi: Kontrollü arşiv çalışması
Küçük Resim Yok
Tarih
2025
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Tip 1 Diyabetes Mellitus (Tip 1 DM), pankreas beta hücrelerinin harabiyeti sonucu insülin eksikliğiyle karakterizedir ve tedavisi eksojen insülin replasmanıyla sağlanır. Son yıllarda, yoğun insülin tedavileri, insülin pompası ve sürekli kan şekeri izleme sistemleri (CGM) gibi teknolojik gelişmeler, Tip 1 DM yönetiminde önemli ilerlemeler sağlamıştır. Bu çalışmada, Düzce Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Polikliniklerine başvuran Tip 1 DM tanılı çocuklarda insülin tedavi çeşitlerinin somatik büyümeye etkisinin araştırılması amaçlanmıştır. Gereç-Yöntem: Çalışmaya 2013-2024 yılları arasında Düzce Üniversitesi Araştırma ve Uygulama Hastanesi Çocuk Endokrinoloji polikliniğine başvuran 85 pompa insülini kullanan ve 85 kalem insülini kullanan tip 1 DM hastası ile pediatri polikliniğine başvuran 85 sağlıklı çocuk dahil edildi. Hastaların takiplerindeki somatik büyümede kullanılan boy, kilo, persentil değerleri retrospektif hasta dosyalarından alınıp veriler analiz edilerek değerlendirilmiştir. Bulgular: Kalem insülin tedavisi kullanan hastaların boy persentillerinde (p=0,615) anlamlı bir değişiklik gözlenmezken pompa insülin tedavisi kullanan hastaların boy persentillerinde (p=0,013) anlamlı azalma görülmüştür. Hem pompa insülin hem de kalem insülin kullanan hastaların kilo persentillerinde (sırasıyla p=0,182, p=0,813) anlamlı bir değişiklik görülmemiştir. Hastaların kullandıkları insülin tedavileri sonucunda Hba1c değerlerinde (p<0,001) anlamlı seviyelerde düşüklük olmuştur. Sonuç: Pompa insülin kullanan hastalarda boy persentilindeki azalma dikkate alınarak, hastaların büyüme gelişmeleri daha yakından izlenmeli ve uzun dönemli çalışmalarla pompa insülinin büyüme üzerindeki etkileri daha detaylı incelenmelidir. Ciddi hipoglisemi riski yüksek olan hastalarda tedavi protokolleri gözden geçirilmeli hastaların ve ailelerin bilinçlendirilmesi için eğitim programları düzenlenmelidir. Pompa insülin ve kalem insülin tedavilerinin uzun dönemli etkilerini karşılaştıran geniş örneklemli çalışmalar yapılmalıdır.
Objective: Type 1 Diabetes Mellitus (Type 1 DM) is characterized by insulin deficiency due to destruction of pancreatic beta cells and is treated with exogenous insulin replacement. In recent years, technological advances such as intensive insulin therapies, insulin pumps and continuous blood glucose monitoring systems (CGM) have led to significant improvements in the management of Type 1 DM. In this study, it was aimed to investigate the effect of insulin treatment types on somatic growth in children with Type 1 DM admitted to Düzce University Faculty of Medicine Pediatrics Outpatient Clinics. Materials and Methods: The study included 85 patients with type 1 DM using pump insulin and 85 patients with type 1 DM using pen insulin who applied to the Pediatric Endocrinology outpatient clinic of Düzce University Research and Practice Hospital between 2013 and 2024 and 85 healthy children who applied to the pediatrics outpatient clinic. The height, weight and percentile values used in somatic growth during the follow-up of the patients were obtained retrospectively from the patient files and the data were analyzed and evaluated. Results: While no significant change was observed in the height percentiles of patients using pen insulin therapy (p=0.615), a significant decrease was observed in the height percentiles of patients using pump insulin therapy (p=0.013). There was no significant change in the weight percentiles of patients using both pump insulin and pen insulin (p=0.182, p=0.813, respectively). There was a significant decrease in HbA1c values (p<0.001) as a result of the insulin treatments used by the patients Conclusion: Considering the decrease in the height percentile in patients using pump insulin, the growth development of patients should be monitored more closely and the effects of pump insulin on growth should be examined in more detail with long-term studies. Treatment protocols should be reviewed in patients with a high risk of severe hypoglycemia and educational programs should be organized to raise awareness of patients and families. Large-sample studies comparing the long-term effects of pump insulin and pen insulin treatments should be conducted.
Objective: Type 1 Diabetes Mellitus (Type 1 DM) is characterized by insulin deficiency due to destruction of pancreatic beta cells and is treated with exogenous insulin replacement. In recent years, technological advances such as intensive insulin therapies, insulin pumps and continuous blood glucose monitoring systems (CGM) have led to significant improvements in the management of Type 1 DM. In this study, it was aimed to investigate the effect of insulin treatment types on somatic growth in children with Type 1 DM admitted to Düzce University Faculty of Medicine Pediatrics Outpatient Clinics. Materials and Methods: The study included 85 patients with type 1 DM using pump insulin and 85 patients with type 1 DM using pen insulin who applied to the Pediatric Endocrinology outpatient clinic of Düzce University Research and Practice Hospital between 2013 and 2024 and 85 healthy children who applied to the pediatrics outpatient clinic. The height, weight and percentile values used in somatic growth during the follow-up of the patients were obtained retrospectively from the patient files and the data were analyzed and evaluated. Results: While no significant change was observed in the height percentiles of patients using pen insulin therapy (p=0.615), a significant decrease was observed in the height percentiles of patients using pump insulin therapy (p=0.013). There was no significant change in the weight percentiles of patients using both pump insulin and pen insulin (p=0.182, p=0.813, respectively). There was a significant decrease in HbA1c values (p<0.001) as a result of the insulin treatments used by the patients Conclusion: Considering the decrease in the height percentile in patients using pump insulin, the growth development of patients should be monitored more closely and the effects of pump insulin on growth should be examined in more detail with long-term studies. Treatment protocols should be reviewed in patients with a high risk of severe hypoglycemia and educational programs should be organized to raise awareness of patients and families. Large-sample studies comparing the long-term effects of pump insulin and pen insulin treatments should be conducted.
Açıklama
Anahtar Kelimeler
Aile Hekimliği, Family Medicine, Endokrinoloji ve Metabolizma Hastalıkları, Tip 1 Diyabetes Mellitus, Sürekli cilt altı enjeksiyonu (SCII), Çoklu günlük insülin (MDI), somatik büyüme, Type 1 Diabetes Mellitus, SCII, MDI, somatic growth
