CORRELATIONS OF CARDIOVASCULAR INDICATORS IN INSULIN-DEPENDENT DIABETES IN CHILDREN

Abstract

In the study we examined children with type 1 diabetes, aged 8 to 17 years, divided into groups depending on the duration of the disease (up to 5 years and over 5 years) in order to study the electrocardiographic changes by daily Holter ECG monitoring depending on the duration of the disease, glycaemia and insulin therapy. Holter ECG monitoring was performed by ECG monitoring complex “DiaCard” ("SOLVAIG" JSC, Kyiv, Ukraine). During the monitoring, the subjects kept a diary of activity with a record of the symptoms, time and dose of insulin and other drugs, as well as indicators of glycaemia, time and quality of sleep. In addition to arrhythmias and conduction parameters, standard parameters of the whole ECG were determined, including ST segment analysis, as well as QT and QT corrected intervals and their dispersion. All ECG parameters per day were evaluated in comparison with the normative values of heart rate in healthy children according to sex and age. The results indicate that regardless of the duration of the disease, there are cardiac dysrhythmias, mainly associated with changes in the automatism of the sinus node and increased activity of ectopic foci of rhythm, which weakens the parasympathetic effects on the heart. Correlation analysis of the detected ECG changes in patients confirmed the progressive effect of the sympathetic part of the autonomic nervous system on heart rate, the relationship of glycaemia with repolarization of ventricles and heart rate, cardiac arrhythmias with changes in sleep structure and awakening according to heart rate. These data can be used to optimize the diagnosis of diabetic heart disease in children and to identify patients who need close attention from cardiologists.