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Adıyaman İlindeki Diyabetik Çocukların Epidemiyolojik Özellikleri

Yıl 2019, Cilt: 17 Sayı: 1, 1 - 16, 01.04.2019

Öz

GİRİŞ ve AMAÇ: Retrospektif olarak planlanan çalışma ile diyabetes mellitus (DM) tanısı alan 0-18 yaş arası hastaların klinik ve laboratuvar bulguları ile epidemiyolojik özelliklerinin değerlendirilmesi amaçlanmıştır. YÖNTEM ve GEREÇLER: Çalışmaya Ekim 2016 ile Ağustos 2018 tarihleri arasında Adıyaman Eğitim ve Araştırma Hastanesi Çocuk Endokrinolojisi Kliniği’nde yeni DM tanısı konulan 78 olgu alındı. Hastalar, tanı yaşına ve diyabet türüne [Neonatal DM, Tip 1 DM, Tip 2 DM, Gençlikte Ortaya Çıkan Erişkin Tip Diyabet (MODY)] göre dört gruba ayrıldı.
BULGULAR: Diyabet tipleri açısından hastalar incelendiğinde 45 hastada Tip 1DM (%57,7), 13 hastada Tip 2DM (%16,7), 15 hastada MODY tip 2 (%19,2), üç hastada MODY tip 3 (%3,9) ve 2 hastada neonatal DM (%2,5) tespit edildi. Tip 1 DM’nin görülme yaşının sırasıyla 10-14 yaş (%35,6) ve 5-9 yaş (%31,1) grubunda zirve yaptığı görüldü. Cinsiyet açısından gruplar karşılaştırıldığında 0-4 yaş ile 5-9 yaş grubunda kız cinsiyet, 10-14 yaş ile 15-17 yaş grubunda erkek cinsiyet üstünlüğü mevcuttu. Tip 2DM’li hastaların 9’u (%69,2) kız, 4’ü (%30,8) erkek ve tanı anındaki yaş ortalaması 13,2±2,4 yıl idi. MODY olgularının 15’ini (%83,3) GCK-MODY ve 3’ünü (%16,7) HNF1A-MODY olgularının oluşturduğu görüldü.
TARTIŞMA ve SONUÇ: Çalışmamızda Adıyaman ilindeki T1DM’li çocukların en sık 10-14 yaş arasında tanı aldığını ve hastalığın 10 yaş altında kızlarda, 10 yaş üzerinde ise erkeklerde daha sık ortaya çıktığını saptadık. T2DM’li çocukların ise ortalama 13,2 yaşında tanı aldığını ve bu hastalarda kız cinsiyet üstünlüğü olduğunu belirledik. Bölgemizde tüm diyabet nedenleri içinde monogenik diyabetin, özellikle de GCK-MODY’nin önemli bir yer işgal ettiğini gösterdik.

Kaynakça

  • 1. American Diyabetes Association. Diagnosis and classification of diyabetes mellitus. Diyabetes Care 2014;37:81–90.
  • 2. American Diyabetes Association. Classification and Diagnosis of Diyabetes. Diyabetes Care 2016;39:13–22.
  • 3. Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diyabetes. Lancet 2014;383:69–82.
  • 4. Ziegler AG, Nepom GT. Prediction and Pathogenesis in Type 1 Diyabetes. Immunity. Elsevier Inc.; 2010;32:468–78.
  • 5. Tieh P, Dreimane D. Type 2 diyabetes mellitus in children and adolescents. Indian J Pediatr 2014;81(2):165-9.
  • 6. Copeland KC, Silverstein J, Moore KR, Prazar GE, Raymer T, Shiffman RN, et al. Management of newly diagnosed type 2 Diyabetes Mellitus (T2DM) in children and adolescents. Pediatrics 2013;131:364–82.
  • 7. Vaxillaire M, Froguel P. Monogenic diyabetes in the young, pharmacogenetics and relevance to multifactorial forms of type 2 diyabetes. Endocr Rev 2008;29(3):254-64.
  • 8. Shields BM, Hicks S, Shepherd MH, Colclough K, Hattersley AT, Ellard S. Maturity-onset diyabetes of the young (MODY): how many cases are we missing? Diyabetologia 2010;53(12):2504-8
  • 9. Iafusco D, Massa O, Pasquino B, Colombo C, Iughetti L, Bizzarri C, et al. Minimal incidence of neonatal/infancy onset diabetes in Italy is 1:90,000 live births. Acta Diabetol 2012;49(5):405–8.
  • 10. Stanik J, Gasperikova D, Paskova M, Barak L, Javorkova J, Jancova E, et al. Prevalence of permanent neonatal diabetes in Slovakia and successful replacement of insulin with sulfonylurea therapy in KCNJ11 and ABCC8 mutation carriers. J Clin Endocrinol Metab 2007;92(4):1276-82.
  • 11. Aguilar-Bryan L, Bryan J. Neonatal diabetes mellitus. Endocr Rev 2008;29(3):265-91.
  • 12. Naylor RN, Greeley SA, Bell GI, Philipson LH. Genetics and pathophysiology of neonatal diabetes mellitus. J Diabetes Investig 2011;2(3):158–69.
  • 13. Ke Huang, Li Liang, Jun-feng Fu, Guan-pin Dong. Permanent neonatal diyabetes mellitus in China. BMC Pediatr 2014;14:188.
  • 14. Kakleas K, Soldatou A, Karachaliou F, Karavanaki K. Associated autoimmune diseases in children and adolescents with type 1 diabetes mellitus(T1DM). Autoimmun Rev 2015;14(9):781-97.
  • 15. Dabelea D, Bell RA, D’Agostino RB Jr, et al. Incidence of diabetes in youth in the United States. JAMA 2007;297:2716–24.
  • 16. DIAMOND Project Group. Incidence and trends of childhood Type 1 diabetes worldwide 1990–1999. Diabet Med 2006;23:857–66.
  • 17. Patterson CC, Dahlquist GG, Gyürüs E, Green A, Soltész G; EURODIAB Study Group. Incidence trends for childhood type 1 diabetes in Europe during 1989-2003 and predicted new cases 2005-20: a multicentre prospective registration study. Lancet 2009;373:2027–33.
  • 18. Maahs DM, West NA, Lawrence JM, Mayer-Davis EJ. Epidemiology of type 1 diabetes. Endocrinol Metab Clin North Am 2010;39:481-97.
  • 19. Shashaj B, Sulli N. Difference in insulin usage patterns with pubertal development in children with type 1 diabetes during transition from multiple daily injections to continuous subcutaneous insulin infusion (CSII) and through the CSII treatment. Diabetes Technol Ther 2009;11:767-74.
  • 20. Yeşilkaya E, Cinaz P, Andıran N, Bideci A, Hatun Ş, Sarı E, et al. First report on the nationwide incidence and prevalence of Type 1 diabetes among children in Turkey. Diabet Med 201;34(3):405-10.
  • 21. Demiral M, Binay Ç, Şimşek E. Eskişehir ilinde tip 1 diyabetes mellitus tanısı ile izlenen hastaların epidemiyolojik özellikleri. Çocuk Sağlığı ve Hastalıkları Dergisi 2016;59:14-20.
  • 22. Poyrazoğlu Ş, Bundak R, Yavaş Abalı Z, Önal H, Sarıkaya S, Akgün A,,et al. Incidence of Type 1 Diabetes in Children Aged Below 18 Years During 2013-2015 in Northwest Turkey. J Clin Res Pediatr Endocrinol. 2018 May 23. doi: 10.4274/jcrpe.0025.
  • 23. Handelsman Y, Bloomgarden ZT, Grunberger G, Umpierrez G, Zimmerman RS, Bailey TS, et al. American Association of Clinical Endocrinologists and American College of Endocrinology Clinical Practice Guidelines for Developing a Diabetes Mellitus Comprehensive Care Plan-2015. Endocr Pract 2015;2l:1-87.
  • 24. ISPAD Clinical Practice Consensus Guidelines 2006-2007. Assessment and monitoring of glycemic control in children and adolescents with diyabetes. Pediatric Diyabetes 2007;8:408-18.
  • 25. Ostman J, Lonnberg G, Arnqvist HJ, Blohmé G, Bolinder J, Ekbom Schnell A, et al. Gender differences and temporal variation in the incidence of type 1 diabetes: results of 8012 cases in the nationwide Diabetes Incidence Study in Sweden 1983–2002. J Intern Med 2008;263:386–94.
  • 26. Pundziute-Lycka A, Urbonaite B, Dahlquist G. Infections and risk of Type I (insulin-dependent) diabetes mellitus in Lithuanian children. Diabetologia 2000;43:1229–34.
  • 27. Soltesz G, Patterson CC, Dahlquist G. Worldwide childhood type 1 diabetes incidence--what can we learn from epidemiology? Pediatr Diabetes 2007;8:6–14.
  • 28. Green A, Gale EAM, Patterson CC. Incidence of childhood-onset insulin-dependent diabetes mellitus: the EURODIAB ACE Study. Lancet 1992;339:905–9.
  • 29. Karvonen M, Pitkaniemi M, Pitkaniemi J, Kohtamaki K, Tajima N, Tuomilehto J. Sex difference in the incidence of insulin-dependent diabetes mellitus: an analysis of the recent epidemiological data. World Health Organization DIAMOND Project Group. Diabetes Metab Rev 1997;13:275–91.
  • 30. Levy-Marchal C, Patterson CC, Green A. Geographical variation of presentation at diagnosis of type I diabetes in children: the EURODIAB study. European and Diabetes. Diabetologia 2001;44:75–80.
  • 31. Demirbilek H, Özbek MN, Baran RT. Incidence of type 1 diabetes mellitus in Turkish children from the southeastern region of the country: a regional report. J Clin Res Pediatr Endocrinol 2013;5:98-103.
  • 32. Baker DJ, Drash AL, Escobar O. Diabetic Ketoacidosis. In: Fima Lifshitz (ed). Pediatric Endocrinology. Fourth Edition. New York: Marcel Deccer Inc.; 2003. p 669-82.
  • 33. Demir F, Günöz H, Saka N, Darendereliler F, Bundak R, Baş F, et al. Epidemiologic features of type 1 diabetic patients between 0 and 18 years of age in İstanbul city. J Clin Res Pediatr Endocrinol 2015;7:49-56.
  • 34. Alemzadeh R, Wyatt D.T. Diabetes Mellitus. In: Behrman R.E, Kliegman R.M, Jenson H.B (eds). Nelson Textbook of Pediatrics. 17 edition. Pennsylvania: Elsevier Saunders; 2004. p.1947-72.
  • 35. Schatz D, Krischer J, Horne G, Riley W, Spillar R, Silverstein J, et al. Islet cell antibodies predict insulin-dependent diabetes in United States school age children as powerfully as in unaffected relatives. J Clin Invest 1994;93:2403-7.
  • 36. Niechciał E, Rogowicz-Frontczak A, Piłaciński S, Fichna M, Skowrońska B, Fichna P, et al. Autoantibodies against zinc transporter 8 are related to age and metabolic state in patients with newly diagnosed autoimmune diabetes. Acta Diabetol 2018;55(3):287–94.
  • 37. Ardicli D, Kandemir N, Alikasifoglu A, Ozon A, Gonc N. Clinical characteristics of type 1 diabetes over a 40 year period in Turkey: Secular trend towards earlier age of onset. J Pediatr Endocrinol Metab 2014;27:635-41.
  • 38. Thanabalasingham G, Owen KR. Diagnosis and management of maturity onset diabetes of the young (MODY). BMJ 2011;343:d6044.
  • 39. Larkin ME, Lorenzi GM, Bayless M, Cleary PA, Barnie A, Golden E. Evolution of the study coordinator role: The 28-year experience in diabetes control and complications trial/epidemiology of diabetes ınterventions and complications (DCCT/EDIC). Clin Trials 2012;9:418-25.
  • 40. Lorini R, Klersy C, d'Annunzio G, Massa O, Minuto N, Iafusco D, et al. Maturity-onset diabetes of the young in children with incidental hyperglycemia: a multicenter Italian study of 172 families. Diabetes care 2009;32(10):1864-6.
  • 41. Pihoker C, Gilliam LK, Ellard S, Dabelea D, Davis C, Dolan LM, et al. Prevalence, characteristics and clinical diagnosis of maturity onset diabetes of the young due to mutations in HNF1A, HNF4A, and glucokinase: results from the SEARCH for Diabetes in Youth. J Clin Endocrinol Metab 2013;98(10):4055-62.
  • 42. Fendler W, Borowiec M, Antosik K, Szadkowska A, Deja G, Jarosz-Chobot P, et al. HDL cholesterol as a diagnostic tool for clinical differentiation of GCK-MODY from HNF1A-MODY and type 1 diabetes in children and young adults. Clin Endocrinol (Oxf) 2011;75(3):321-7.
  • 43. Pulgaron ER, Delamater AM. Obesity and type 2 diabetes in children: epidemiology and treatment. Curr Diab Rep 2014;14(8):508.
  • 44. American Diabetes Association. Type 2 diabetes in children and adolescents. Diabetes Care 2000;23:381–9.
  • 45. Kaufman F. Type 2 diabetes in youth: rates, antecedents, treatment, problems and prevention. Pediatr Diabetes 2007;8:4–6.
  • 46. Rosenbloom AL, Silverstein JH, Amemiya S, Zeitler P, Klingensmith G. ISPAD Clinical Practice Consensus Guidelines 2006-2007. Type 2 diabetes mellitus in the child and adolescent. Pediatr Diabetes 2009;9:512–26.
  • 47. Reihner T. Type 2 diabetes mellitus in children and adolescents. World J Diabetes 2013;4:270–81.
  • 48. Arslanian SA. Type 2 diabetes mellitus in children: pathophysiology and risk factors. J Pediatr Endocrinol Metab 2000;13:1385–94.
  • 49. Flanagan SE, Patch AM, Mackay DJ, Edghill EL, Gloyn AL, Robinson D, et al. Mutations in ATP-sensitive K+ channel genes cause transient neonatal diabetes and permanent diabetes in childhood or adulthood. Diabetes 2007;56(7):1930-7.
  • 50. Dupont J, Pereira C, Medeira A, Duarte R, Ellard S, Sampaio L. Permanent neonatal diabetes mellitus due to KCNJ11 mutation in a Portuguese family: transition from insulin to oral sulfonylureas. J Pediatr Endocrinol Metab 2012;25:367-70.

The Epidemiological Characteristics of Diabetic Children in the Province of Adıyaman

Yıl 2019, Cilt: 17 Sayı: 1, 1 - 16, 01.04.2019

Öz

Kaynakça

  • 1. American Diyabetes Association. Diagnosis and classification of diyabetes mellitus. Diyabetes Care 2014;37:81–90.
  • 2. American Diyabetes Association. Classification and Diagnosis of Diyabetes. Diyabetes Care 2016;39:13–22.
  • 3. Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diyabetes. Lancet 2014;383:69–82.
  • 4. Ziegler AG, Nepom GT. Prediction and Pathogenesis in Type 1 Diyabetes. Immunity. Elsevier Inc.; 2010;32:468–78.
  • 5. Tieh P, Dreimane D. Type 2 diyabetes mellitus in children and adolescents. Indian J Pediatr 2014;81(2):165-9.
  • 6. Copeland KC, Silverstein J, Moore KR, Prazar GE, Raymer T, Shiffman RN, et al. Management of newly diagnosed type 2 Diyabetes Mellitus (T2DM) in children and adolescents. Pediatrics 2013;131:364–82.
  • 7. Vaxillaire M, Froguel P. Monogenic diyabetes in the young, pharmacogenetics and relevance to multifactorial forms of type 2 diyabetes. Endocr Rev 2008;29(3):254-64.
  • 8. Shields BM, Hicks S, Shepherd MH, Colclough K, Hattersley AT, Ellard S. Maturity-onset diyabetes of the young (MODY): how many cases are we missing? Diyabetologia 2010;53(12):2504-8
  • 9. Iafusco D, Massa O, Pasquino B, Colombo C, Iughetti L, Bizzarri C, et al. Minimal incidence of neonatal/infancy onset diabetes in Italy is 1:90,000 live births. Acta Diabetol 2012;49(5):405–8.
  • 10. Stanik J, Gasperikova D, Paskova M, Barak L, Javorkova J, Jancova E, et al. Prevalence of permanent neonatal diabetes in Slovakia and successful replacement of insulin with sulfonylurea therapy in KCNJ11 and ABCC8 mutation carriers. J Clin Endocrinol Metab 2007;92(4):1276-82.
  • 11. Aguilar-Bryan L, Bryan J. Neonatal diabetes mellitus. Endocr Rev 2008;29(3):265-91.
  • 12. Naylor RN, Greeley SA, Bell GI, Philipson LH. Genetics and pathophysiology of neonatal diabetes mellitus. J Diabetes Investig 2011;2(3):158–69.
  • 13. Ke Huang, Li Liang, Jun-feng Fu, Guan-pin Dong. Permanent neonatal diyabetes mellitus in China. BMC Pediatr 2014;14:188.
  • 14. Kakleas K, Soldatou A, Karachaliou F, Karavanaki K. Associated autoimmune diseases in children and adolescents with type 1 diabetes mellitus(T1DM). Autoimmun Rev 2015;14(9):781-97.
  • 15. Dabelea D, Bell RA, D’Agostino RB Jr, et al. Incidence of diabetes in youth in the United States. JAMA 2007;297:2716–24.
  • 16. DIAMOND Project Group. Incidence and trends of childhood Type 1 diabetes worldwide 1990–1999. Diabet Med 2006;23:857–66.
  • 17. Patterson CC, Dahlquist GG, Gyürüs E, Green A, Soltész G; EURODIAB Study Group. Incidence trends for childhood type 1 diabetes in Europe during 1989-2003 and predicted new cases 2005-20: a multicentre prospective registration study. Lancet 2009;373:2027–33.
  • 18. Maahs DM, West NA, Lawrence JM, Mayer-Davis EJ. Epidemiology of type 1 diabetes. Endocrinol Metab Clin North Am 2010;39:481-97.
  • 19. Shashaj B, Sulli N. Difference in insulin usage patterns with pubertal development in children with type 1 diabetes during transition from multiple daily injections to continuous subcutaneous insulin infusion (CSII) and through the CSII treatment. Diabetes Technol Ther 2009;11:767-74.
  • 20. Yeşilkaya E, Cinaz P, Andıran N, Bideci A, Hatun Ş, Sarı E, et al. First report on the nationwide incidence and prevalence of Type 1 diabetes among children in Turkey. Diabet Med 201;34(3):405-10.
  • 21. Demiral M, Binay Ç, Şimşek E. Eskişehir ilinde tip 1 diyabetes mellitus tanısı ile izlenen hastaların epidemiyolojik özellikleri. Çocuk Sağlığı ve Hastalıkları Dergisi 2016;59:14-20.
  • 22. Poyrazoğlu Ş, Bundak R, Yavaş Abalı Z, Önal H, Sarıkaya S, Akgün A,,et al. Incidence of Type 1 Diabetes in Children Aged Below 18 Years During 2013-2015 in Northwest Turkey. J Clin Res Pediatr Endocrinol. 2018 May 23. doi: 10.4274/jcrpe.0025.
  • 23. Handelsman Y, Bloomgarden ZT, Grunberger G, Umpierrez G, Zimmerman RS, Bailey TS, et al. American Association of Clinical Endocrinologists and American College of Endocrinology Clinical Practice Guidelines for Developing a Diabetes Mellitus Comprehensive Care Plan-2015. Endocr Pract 2015;2l:1-87.
  • 24. ISPAD Clinical Practice Consensus Guidelines 2006-2007. Assessment and monitoring of glycemic control in children and adolescents with diyabetes. Pediatric Diyabetes 2007;8:408-18.
  • 25. Ostman J, Lonnberg G, Arnqvist HJ, Blohmé G, Bolinder J, Ekbom Schnell A, et al. Gender differences and temporal variation in the incidence of type 1 diabetes: results of 8012 cases in the nationwide Diabetes Incidence Study in Sweden 1983–2002. J Intern Med 2008;263:386–94.
  • 26. Pundziute-Lycka A, Urbonaite B, Dahlquist G. Infections and risk of Type I (insulin-dependent) diabetes mellitus in Lithuanian children. Diabetologia 2000;43:1229–34.
  • 27. Soltesz G, Patterson CC, Dahlquist G. Worldwide childhood type 1 diabetes incidence--what can we learn from epidemiology? Pediatr Diabetes 2007;8:6–14.
  • 28. Green A, Gale EAM, Patterson CC. Incidence of childhood-onset insulin-dependent diabetes mellitus: the EURODIAB ACE Study. Lancet 1992;339:905–9.
  • 29. Karvonen M, Pitkaniemi M, Pitkaniemi J, Kohtamaki K, Tajima N, Tuomilehto J. Sex difference in the incidence of insulin-dependent diabetes mellitus: an analysis of the recent epidemiological data. World Health Organization DIAMOND Project Group. Diabetes Metab Rev 1997;13:275–91.
  • 30. Levy-Marchal C, Patterson CC, Green A. Geographical variation of presentation at diagnosis of type I diabetes in children: the EURODIAB study. European and Diabetes. Diabetologia 2001;44:75–80.
  • 31. Demirbilek H, Özbek MN, Baran RT. Incidence of type 1 diabetes mellitus in Turkish children from the southeastern region of the country: a regional report. J Clin Res Pediatr Endocrinol 2013;5:98-103.
  • 32. Baker DJ, Drash AL, Escobar O. Diabetic Ketoacidosis. In: Fima Lifshitz (ed). Pediatric Endocrinology. Fourth Edition. New York: Marcel Deccer Inc.; 2003. p 669-82.
  • 33. Demir F, Günöz H, Saka N, Darendereliler F, Bundak R, Baş F, et al. Epidemiologic features of type 1 diabetic patients between 0 and 18 years of age in İstanbul city. J Clin Res Pediatr Endocrinol 2015;7:49-56.
  • 34. Alemzadeh R, Wyatt D.T. Diabetes Mellitus. In: Behrman R.E, Kliegman R.M, Jenson H.B (eds). Nelson Textbook of Pediatrics. 17 edition. Pennsylvania: Elsevier Saunders; 2004. p.1947-72.
  • 35. Schatz D, Krischer J, Horne G, Riley W, Spillar R, Silverstein J, et al. Islet cell antibodies predict insulin-dependent diabetes in United States school age children as powerfully as in unaffected relatives. J Clin Invest 1994;93:2403-7.
  • 36. Niechciał E, Rogowicz-Frontczak A, Piłaciński S, Fichna M, Skowrońska B, Fichna P, et al. Autoantibodies against zinc transporter 8 are related to age and metabolic state in patients with newly diagnosed autoimmune diabetes. Acta Diabetol 2018;55(3):287–94.
  • 37. Ardicli D, Kandemir N, Alikasifoglu A, Ozon A, Gonc N. Clinical characteristics of type 1 diabetes over a 40 year period in Turkey: Secular trend towards earlier age of onset. J Pediatr Endocrinol Metab 2014;27:635-41.
  • 38. Thanabalasingham G, Owen KR. Diagnosis and management of maturity onset diabetes of the young (MODY). BMJ 2011;343:d6044.
  • 39. Larkin ME, Lorenzi GM, Bayless M, Cleary PA, Barnie A, Golden E. Evolution of the study coordinator role: The 28-year experience in diabetes control and complications trial/epidemiology of diabetes ınterventions and complications (DCCT/EDIC). Clin Trials 2012;9:418-25.
  • 40. Lorini R, Klersy C, d'Annunzio G, Massa O, Minuto N, Iafusco D, et al. Maturity-onset diabetes of the young in children with incidental hyperglycemia: a multicenter Italian study of 172 families. Diabetes care 2009;32(10):1864-6.
  • 41. Pihoker C, Gilliam LK, Ellard S, Dabelea D, Davis C, Dolan LM, et al. Prevalence, characteristics and clinical diagnosis of maturity onset diabetes of the young due to mutations in HNF1A, HNF4A, and glucokinase: results from the SEARCH for Diabetes in Youth. J Clin Endocrinol Metab 2013;98(10):4055-62.
  • 42. Fendler W, Borowiec M, Antosik K, Szadkowska A, Deja G, Jarosz-Chobot P, et al. HDL cholesterol as a diagnostic tool for clinical differentiation of GCK-MODY from HNF1A-MODY and type 1 diabetes in children and young adults. Clin Endocrinol (Oxf) 2011;75(3):321-7.
  • 43. Pulgaron ER, Delamater AM. Obesity and type 2 diabetes in children: epidemiology and treatment. Curr Diab Rep 2014;14(8):508.
  • 44. American Diabetes Association. Type 2 diabetes in children and adolescents. Diabetes Care 2000;23:381–9.
  • 45. Kaufman F. Type 2 diabetes in youth: rates, antecedents, treatment, problems and prevention. Pediatr Diabetes 2007;8:4–6.
  • 46. Rosenbloom AL, Silverstein JH, Amemiya S, Zeitler P, Klingensmith G. ISPAD Clinical Practice Consensus Guidelines 2006-2007. Type 2 diabetes mellitus in the child and adolescent. Pediatr Diabetes 2009;9:512–26.
  • 47. Reihner T. Type 2 diabetes mellitus in children and adolescents. World J Diabetes 2013;4:270–81.
  • 48. Arslanian SA. Type 2 diabetes mellitus in children: pathophysiology and risk factors. J Pediatr Endocrinol Metab 2000;13:1385–94.
  • 49. Flanagan SE, Patch AM, Mackay DJ, Edghill EL, Gloyn AL, Robinson D, et al. Mutations in ATP-sensitive K+ channel genes cause transient neonatal diabetes and permanent diabetes in childhood or adulthood. Diabetes 2007;56(7):1930-7.
  • 50. Dupont J, Pereira C, Medeira A, Duarte R, Ellard S, Sampaio L. Permanent neonatal diabetes mellitus due to KCNJ11 mutation in a Portuguese family: transition from insulin to oral sulfonylureas. J Pediatr Endocrinol Metab 2012;25:367-70.
Toplam 50 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma
Yazarlar

Fatih İşleyen

Semih Bolu Bu kişi benim

Yayımlanma Tarihi 1 Nisan 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 17 Sayı: 1

Kaynak Göster

APA İşleyen, F., & Bolu, S. (2019). Adıyaman İlindeki Diyabetik Çocukların Epidemiyolojik Özellikleri. Güncel Pediatri, 17(1), 1-16. https://doi.org/10.32941/pediatri.544461
AMA İşleyen F, Bolu S. Adıyaman İlindeki Diyabetik Çocukların Epidemiyolojik Özellikleri. Güncel Pediatri. Nisan 2019;17(1):1-16. doi:10.32941/pediatri.544461
Chicago İşleyen, Fatih, ve Semih Bolu. “Adıyaman İlindeki Diyabetik Çocukların Epidemiyolojik Özellikleri”. Güncel Pediatri 17, sy. 1 (Nisan 2019): 1-16. https://doi.org/10.32941/pediatri.544461.
EndNote İşleyen F, Bolu S (01 Nisan 2019) Adıyaman İlindeki Diyabetik Çocukların Epidemiyolojik Özellikleri. Güncel Pediatri 17 1 1–16.
IEEE F. İşleyen ve S. Bolu, “Adıyaman İlindeki Diyabetik Çocukların Epidemiyolojik Özellikleri”, Güncel Pediatri, c. 17, sy. 1, ss. 1–16, 2019, doi: 10.32941/pediatri.544461.
ISNAD İşleyen, Fatih - Bolu, Semih. “Adıyaman İlindeki Diyabetik Çocukların Epidemiyolojik Özellikleri”. Güncel Pediatri 17/1 (Nisan 2019), 1-16. https://doi.org/10.32941/pediatri.544461.
JAMA İşleyen F, Bolu S. Adıyaman İlindeki Diyabetik Çocukların Epidemiyolojik Özellikleri. Güncel Pediatri. 2019;17:1–16.
MLA İşleyen, Fatih ve Semih Bolu. “Adıyaman İlindeki Diyabetik Çocukların Epidemiyolojik Özellikleri”. Güncel Pediatri, c. 17, sy. 1, 2019, ss. 1-16, doi:10.32941/pediatri.544461.
Vancouver İşleyen F, Bolu S. Adıyaman İlindeki Diyabetik Çocukların Epidemiyolojik Özellikleri. Güncel Pediatri. 2019;17(1):1-16.