Распространенность отклонений физического развития у детей с сахарным диабетом 1-го типа в зависимости от степени его компенсации

Abstract

Type 1 diabetes (T1D) is the most common type of diabetes in children and adolescents. Patients with T1D have traditionally been thought to have lower BMI, however recent research has demonstrated a high prevalence of overweight and obesity with the development of metabolic syndrome. Objective. To study the characteristics of physical development of children with T1D depending on the degree of its compensation. Patients and methods. A retrospective analysis of medical records of children with T1D aged 7 to 17 years (n = 318) who underwent routine inpatient examination and treatment in the pediatric department of the Children’s Regional Clinical Hospital of Khabarovsk Krai between 2018 and 2023 was performed. Depending on the level of glycated hemoglobin (HbA1c), children were divided into three study groups: group 1 (n = 40) – HbA1c less than 7%, group 2 (n = 100) – HbA1c from 7.1 to 8.5%, group 3 (n = 178) – HbA1c over 8.5%. Physical development was assessed according to the WHO standards. Results. The analysis of physical development of all children without considering the degree of diabetes compensation showed that malnutrition was observed in 1.9% of patients, overweight in 17.0% and obesity in 1.6%, tall stature was diagnosed in 2.8%, reduced growth rate and short stature were determined in 11.6% and 1.9%, respectively. It should be emphasized that HAZ and BAZ values greater than +2 and less than -2 were not recorded in patients with achieved target HbA1c levels. The incidence of reduced growth rate and malnutrition was 3 and 2 times higher in the group of children with decompensated diabetes, respectively, compared to those with HbA1c below 8.5% (OR = 2.959, 95% CI: 1.403-6.239; OR = 2.076, 95% CI: 1.018-4.235). Conclusion. The data obtained indicate the predominance of anthropometric deviations in children with uncompensated diabetes, which requires the identification of measures to achieve target HbA1c levels for the prevention of developmental disorders. Key words: glycated hemoglobin, children, type 1 diabetes, physical development