Physical development of adolescents with type 1 diabetes mellitus and the impact of the war in Ukraine on its impairment

Abstract

Purpose: To determine the characteristics of physical development (PD) of adolescents with type 1 diabetes mellitus (T1DM) and the impact of the war in Ukraine on its nature. Material and methods: The nature of physical development (PD) was assessed in adolescents with T1DM aged 14–18 years, examined before the start of the war on 24.02.2022 (main group, n = 114) and after 01.10.2022 (comparison group, n=76). The study was conducted in accordance with the principles of the Declaration of Helsinki and accepted by the Committee on Bioethics and Deontology. The examination of patients was carried out in accordance with the standards of medical care “Diabetes mellitus in children”, approved by Order of the Ministry of Health No. 413 of February 28, 2023 (Order of the Ministry of Health of Ukraine, 2023) and protocol for providing medical care to children in the specialty “pediatric endocrinology” (Order of the Ministry of Health of Ukraine, 2013). Results: It was proven that 29,1% of modern adolescents 14-17 years old, patients with T1DM, had a disharmonic PD, the nature of which depended on gender and the state of glycemic control. Girls were more likely to have impaired growth (21,0%) and overweight (12,8%), while boys were diagnosed with tall stature (8,9%) and underweight (8,9%). More often, PD disturbances were observed in the case of stable decompensation of carbohydrate metabolism with a decrease in the time spent in the target range and high levels of glycemic variability during the day. Among adolescents with T1DM during the period of hostilities in Ukraine, the number of adolescents with disharmonious PD increased (36,7%, P<0,05), which may be due to a deterioration in glycemic control. In boys, an increase in the percentage of patients with underweight (20,0%, P<0,05) and with short stature (4,0%, P<0,05) was recorded, and in girls - with overweight (29,9 %, P<0,05). Conclusions: confirms the negative impact of T1DM on RF, especially when socio-economic conditions worsen during armed conflicts. The relationship between the nature of risk factors, gender, the state of glycemic control and unfavorable living conditions during the war in Ukraine was determined.