Derleme
BibTex RIS Kaynak Göster

Type 1 Diabetes in Childhood

Yıl 2016, Cilt: 8 Sayı: 6, 22 - 32, 08.11.2016

Öz

Abstract

Type 1 diabetes mellitus (T1DM) or insulin dependent DM is characterised bysevere insulin openia and dependency on exogeneous insulin to prevent ketosis andto maintain normal life. Although the vast majority of the cases occur in childhood,it can be observed at any age. There are two subgroups of T1DM as immune mediated type 1a and idiopathic type 1b. The classical presentation of diabetes in children includes polyuria, polydipsia, polyphagia and history of weight loss. In cases withlong lasting complaints, presentation with ketoacidosis, which is associated with highmorbidity and the mortality is possible. The treatment of the patient with T1DM should be individualized considering the nutritional habits and the life style of the patient and treatment and follow-up of the patients should be performed  by an experienced pediatric endocrinologist. Because T1DM encompasses a large fraction ofpediatric diabetes, brief  updates on the diagnosis, treatment and complications weredescribed in this review. 

Kaynakça

  • Kaynaklar 1. Sperling MA, Tamborlane WV, Battelino T, et al. Diabe-tes Mellitus. In: Sperling M, ed. Pediatric Endocrinology,Fourth ed, 2014: 846-900. 2. Ize-Ludow D, Sperling M. The classification of DiabetesMellitus: A conceptual Framework. Pediatr Clin N Am2005; 52, 1533-52. 3. Atkinson MA, Eisenbarth GS, Michels AW. Type 1 dia-betes. Lancet, 2013; S0140-6736: 60591-69597. 4. Eisenbarth GS. Update in type 1 diabetes. J Clin Endoc-rinol Metab 2007; 92: 2403-407. 5. Harjutsalo V, Sund R, Knip M, et al. Incidence of type1 diabetes in Finland. JAMA 2013; 310: 427-28. 6. Forlenza GP, Rewers M. The epidemic of type 1 diabetes:what is it telling us? Curr Opin Endocrinol Diabetes Obes2011; 18: 248-51. 7. Tuomilehto J. The emerging global epidemic of type 1 diabe-tes. Curr Diab Rep 2013 Doi: 10.1007/s11892-013-0433-5. 8. Libman IM, LaPorte RE, Becker DJ, et al. Was there anepidemic of diabetes in nonwhite adolescents in AlleghenyCounty, Pennsylvania? Diabetes Care 1998; 21:1278-81. 9. Akesen E, Turan S, Guran T, et al. Prevalence of type 1 dia-betes mellitus in 6–18-yr-old school children living in Istan-bul, Turkey. Pediatric Diabetes 2011; 12 (6): 567-71. 10. Demirbilek H, Ozbek MN, Baran RT. Incidence of type1 diabetes mellitus in Turkish children from the southeas-tern region of the country: A regional report J Clin ResPediatr Endocrinol 2013; 5 (2): 98-103. 11. Imagawa A, Hanafusa T, Miyagawa JI, et al. A novelsubtype of type 1 diabetes mellitus characterized by a ra-pid onset and an absence of diabetes- related autoantibo-dies. N Engl J Med 2000; 342: 301-307. 12. Knip M, Veijola R, Virtanen SM, et al. Environmentaltriggers and determinants of type 1 diabetes. Diabetes2005; 54, S125-S136. 13. Craig ME, Nair S, Stein H, Rawlinson WD. Viruses andtype 1 diabetes: a new look at an old story. Pediatr Dia-betes 2013; 14, 149-58. 14. Eisenbarth GS. Banting lecture 2009: an unfinished jo-urney: molecular pathogenesis to prevention of type 1 Adiabetes. Diabetes 2010; 59: 759-74. 15. Barrett JC, Clayton DG, Concannon P, et al. Genomewi-de association study and meta-analysis find that over 40 lociaffect risk of type 1 diabetes. Nat Genet 2009; 41: 703-707. 16. Atkinson MA, Eisenbarth GS, Michels AW. Type 1 dia-betes. Lancet 2007, S0140-6736, 60591-60597. 17. Atkinson MA, Conrad B, Trucco M. Superantigens as etio-pathogenetic factors in the development of insulin depen-dent diabetes mellitus. Diabetes Metab Rev 1994; 10: 309. 18. Skyler JS. Primary and secondary prevention of type 1diabetes . Diabet Med 2013; 30: 161-69. 19. Barker JM, McFann KK, Orban T. Primary preventionof Type 1 A Diabetes? Are we there yet? Pediatr Diabe-tes 2007; 8: 115-16. 20. Verge CF, Gianani R, Kawasaki E, et al. Prediction of type1 diabetes in first-degree relatives using a combination ofinsulin, GAD, and ICA512bdc/IA-s autoantibodies. Dia-betes 1996; 45: 926. 21. Schade DS, Eaton RP. The temporal relationship betwe-en endogeneously secreted stress hormones and metabo-lic decompensation in diabetic man. J Clin Endocrinol Me-tab 1980; 50: 131-36. 22. American Diabetes Association. Standards of medical carein diabetes –2011. Diabetes Care 2011; 34 Suppl 1: S11-61. 23. Foster DW, McGarry JD. The metabolic derangementsand treatment of diabetic ketoacidosis. New Engl J Med1983; 309: 159-69. 24. Wolfsdorf JI, Allgrove J, Craig ME, et al. Diabetic ke-toacidosis and hyperglycemic hyperosmolar state. PediatrDiabetes 2014; 15 (Suppl 20): 154-79. 25. Deeter KH, Roberts JS, Bradford H, et al. Hypertensi-on despite dehydration during severe pediatric diabetic ke-toacidosis. Pediatr Diabetes 2011: 12: 295-301. 26. Carlotti AP, St George-Hyslop C, Guerguerian AM, etal. Occult risk factor for the development of cerebral ede-ma in children with diabetic ketoacidosis: possible role forstomach emptying. Pediatr Diabetes 2009: 10: 522-33. 27. Sheikh-Ali M, Karon BS, Basu A, et al. Can serum beta-hydroxybutyrate be used to diagnose diabetic ketoacido-sis? Diabetes Care 2008: 31: 631-47. 28. Chase HP, Garg SK, Jelley DH. Diabetic ketoacidosis inchildren and the role of outpatient management. PediatrRev 1990: 11: 297-304. 29. Bagdure D, Rewers A, Campagna E, Sills MR. Epidemio-logy of hyperglycemic hyperosmolar syndrome in childrenhospitalized in USA. Pediatr Diabetes 2013: 14: 18–24. 30.Uçar A, Saka N, Baş F, et al. Frequency and severity of ke-toacidosis at onset of autoimmune type 1 diabetes over the pastdecade in children referred to a tertiary paediatric care cen-tre: potential impact of a national programme highlighted. JPediatr Endocrinol Metab 2013; 26 (11-12): 1059-65. 31. Hanas R, Lindgren F, Lindblad BA. 2-year national po-pulation study of pediatric ketoacidosis in Sweden: pre-disposing conditions and insulin pump use. Pediatr Dia-betes 2009: 10: 33–37. 32. Smith CP, Firth D, Bennett S, Howard C, Chisholm P. Ke-toacidosis occurring in newly diagnosed and establisheddiabetic children. Acta Paediatr 1998: 87: 537–41. 33. Morris AD, Boyle DI, McMahon AD, et al. Adherenceto insulin treatment, glycaemic control, and ketoacidosisin insulin-dependent diabetes mellitus. TheDARTS/MEMO Collaboration. Diabetes Audit and Re-search in Tayside Scotland. Medicines Monitoring Unit.Lancet 1997: 350: 1505–510. 34. Hanas R, Lindgren F, Lindblad BA. 2-year national po-pulation study of pediatric ketoacidosis in Sweden: pre-disposing conditions and insulin pump use. Pediatr Dia-betes 2009: 10: 33–37. 35. Cope JU, Morrison AE, Samuels-Reid J. Adolescent use ofinsulin and patient-controlled analgesia pump technology:a 10-year Food and Drug Administration retrospectivestudy of adverse events. Pediatrics 2008: 121: e1133–e1138. 36.Dunger DB, Sperling MA, Acerini CL, et al. ESPE/LWPESconsensus statement on diabetic ketoacidosis in children andadolescents. Arch Dis Child 2004: 89: 188–94. 37. Monroe KW, King W, Atchison JA. Use of PRISM sco-res in triage of pediatric patients with diabetic ketoacido-sis. Am J Manag Care 1997: 3: 253–58. 38. Bonadio WA, Gutzeit MF, Losek JD, Smith DS. Outpa-tient management of diabetic ketoacidosis. Am J Dis Child1988: 142: 448–50. 39. Linares MY, Schunk JE, Lindsay R. Laboratory presen-tation in diabetic ketoacidosis and duration of therapy. Pe-diatr Emerg Care 1996: 12: 347–51. 40. Malik FS, Taplin CE. Insulin therapy in children and adoles-cents with type 1 diabetes. Pediatr Drugs 2014; 16: 141-50. 41. American Diabetes Association. Standards of medical carein diabetes---2014. Diabetes Care 2014; 37 (Suppl 1): 14-80. 42. Vurallı D, Kandemir N. Tip 1 Diabetes Mellitus. ÇocukEndokrinolojisi; Editörler: Cinaz, Darendeliler, Akıncı, veark., 2014; 15 (2): 399-452.

Çocukluk Çağında Tip 1 Diyabet

Yıl 2016, Cilt: 8 Sayı: 6, 22 - 32, 08.11.2016

Öz

Öz

Tip 1 diabetes mellitus (T1DM) veya insulin bağımlı DM ağır insulinopeni sonucu gelişebilecek ketozun önlenerek yaşamın devam ettirilebilmesi için eksojeninsulin bağımlılığı ile karakterizedir. Her ne kadar büyük oranda çocukluk döneminde başlangıç gösterse de her hangi bir yaşta ortaya çıkabilir. İmmünite ilişkili tip 1a ve idiyopatik tip 1b olmak üzere iki alt grubu vardır. Çocuklarda diyabetin klasik başvuru şekli poliüri, polidipsi, polifaji ve kilo kaybı hikayesinin olmasıdır. Şikayetlerin uzun süre devam ettiği olgularda morbidite ve mortalitesi yüksek olan ketoasidoz ile başvuru olabilir. T1DM tanısı konulan hastalarda tedavi hastanın beslenme ve yaşam biçimi bir bütün olarak değerlendirilip düzenlenmeli vetedavi ve izlemin mutlaka deneyimli pediyatrik endokrinolog tarafından yapılması gerekmektedir. Pediyatrik diyabetin büyük bir kısmını oluşturduğundan bu der-lemede güncel bilgiler doğrultusunda kısaca T1DM  tanı, tedavi ve komplikasyonları ele alınmıştır.

Kaynakça

  • Kaynaklar 1. Sperling MA, Tamborlane WV, Battelino T, et al. Diabe-tes Mellitus. In: Sperling M, ed. Pediatric Endocrinology,Fourth ed, 2014: 846-900. 2. Ize-Ludow D, Sperling M. The classification of DiabetesMellitus: A conceptual Framework. Pediatr Clin N Am2005; 52, 1533-52. 3. Atkinson MA, Eisenbarth GS, Michels AW. Type 1 dia-betes. Lancet, 2013; S0140-6736: 60591-69597. 4. Eisenbarth GS. Update in type 1 diabetes. J Clin Endoc-rinol Metab 2007; 92: 2403-407. 5. Harjutsalo V, Sund R, Knip M, et al. Incidence of type1 diabetes in Finland. JAMA 2013; 310: 427-28. 6. Forlenza GP, Rewers M. The epidemic of type 1 diabetes:what is it telling us? Curr Opin Endocrinol Diabetes Obes2011; 18: 248-51. 7. Tuomilehto J. The emerging global epidemic of type 1 diabe-tes. Curr Diab Rep 2013 Doi: 10.1007/s11892-013-0433-5. 8. Libman IM, LaPorte RE, Becker DJ, et al. Was there anepidemic of diabetes in nonwhite adolescents in AlleghenyCounty, Pennsylvania? Diabetes Care 1998; 21:1278-81. 9. Akesen E, Turan S, Guran T, et al. Prevalence of type 1 dia-betes mellitus in 6–18-yr-old school children living in Istan-bul, Turkey. Pediatric Diabetes 2011; 12 (6): 567-71. 10. Demirbilek H, Ozbek MN, Baran RT. Incidence of type1 diabetes mellitus in Turkish children from the southeas-tern region of the country: A regional report J Clin ResPediatr Endocrinol 2013; 5 (2): 98-103. 11. Imagawa A, Hanafusa T, Miyagawa JI, et al. A novelsubtype of type 1 diabetes mellitus characterized by a ra-pid onset and an absence of diabetes- related autoantibo-dies. N Engl J Med 2000; 342: 301-307. 12. Knip M, Veijola R, Virtanen SM, et al. Environmentaltriggers and determinants of type 1 diabetes. Diabetes2005; 54, S125-S136. 13. Craig ME, Nair S, Stein H, Rawlinson WD. Viruses andtype 1 diabetes: a new look at an old story. Pediatr Dia-betes 2013; 14, 149-58. 14. Eisenbarth GS. Banting lecture 2009: an unfinished jo-urney: molecular pathogenesis to prevention of type 1 Adiabetes. Diabetes 2010; 59: 759-74. 15. Barrett JC, Clayton DG, Concannon P, et al. Genomewi-de association study and meta-analysis find that over 40 lociaffect risk of type 1 diabetes. Nat Genet 2009; 41: 703-707. 16. Atkinson MA, Eisenbarth GS, Michels AW. Type 1 dia-betes. Lancet 2007, S0140-6736, 60591-60597. 17. Atkinson MA, Conrad B, Trucco M. Superantigens as etio-pathogenetic factors in the development of insulin depen-dent diabetes mellitus. Diabetes Metab Rev 1994; 10: 309. 18. Skyler JS. Primary and secondary prevention of type 1diabetes . Diabet Med 2013; 30: 161-69. 19. Barker JM, McFann KK, Orban T. Primary preventionof Type 1 A Diabetes? Are we there yet? Pediatr Diabe-tes 2007; 8: 115-16. 20. Verge CF, Gianani R, Kawasaki E, et al. Prediction of type1 diabetes in first-degree relatives using a combination ofinsulin, GAD, and ICA512bdc/IA-s autoantibodies. Dia-betes 1996; 45: 926. 21. Schade DS, Eaton RP. The temporal relationship betwe-en endogeneously secreted stress hormones and metabo-lic decompensation in diabetic man. J Clin Endocrinol Me-tab 1980; 50: 131-36. 22. American Diabetes Association. Standards of medical carein diabetes –2011. Diabetes Care 2011; 34 Suppl 1: S11-61. 23. Foster DW, McGarry JD. The metabolic derangementsand treatment of diabetic ketoacidosis. New Engl J Med1983; 309: 159-69. 24. Wolfsdorf JI, Allgrove J, Craig ME, et al. Diabetic ke-toacidosis and hyperglycemic hyperosmolar state. PediatrDiabetes 2014; 15 (Suppl 20): 154-79. 25. Deeter KH, Roberts JS, Bradford H, et al. Hypertensi-on despite dehydration during severe pediatric diabetic ke-toacidosis. Pediatr Diabetes 2011: 12: 295-301. 26. Carlotti AP, St George-Hyslop C, Guerguerian AM, etal. Occult risk factor for the development of cerebral ede-ma in children with diabetic ketoacidosis: possible role forstomach emptying. Pediatr Diabetes 2009: 10: 522-33. 27. Sheikh-Ali M, Karon BS, Basu A, et al. Can serum beta-hydroxybutyrate be used to diagnose diabetic ketoacido-sis? Diabetes Care 2008: 31: 631-47. 28. Chase HP, Garg SK, Jelley DH. Diabetic ketoacidosis inchildren and the role of outpatient management. PediatrRev 1990: 11: 297-304. 29. Bagdure D, Rewers A, Campagna E, Sills MR. Epidemio-logy of hyperglycemic hyperosmolar syndrome in childrenhospitalized in USA. Pediatr Diabetes 2013: 14: 18–24. 30.Uçar A, Saka N, Baş F, et al. Frequency and severity of ke-toacidosis at onset of autoimmune type 1 diabetes over the pastdecade in children referred to a tertiary paediatric care cen-tre: potential impact of a national programme highlighted. JPediatr Endocrinol Metab 2013; 26 (11-12): 1059-65. 31. Hanas R, Lindgren F, Lindblad BA. 2-year national po-pulation study of pediatric ketoacidosis in Sweden: pre-disposing conditions and insulin pump use. Pediatr Dia-betes 2009: 10: 33–37. 32. Smith CP, Firth D, Bennett S, Howard C, Chisholm P. Ke-toacidosis occurring in newly diagnosed and establisheddiabetic children. Acta Paediatr 1998: 87: 537–41. 33. Morris AD, Boyle DI, McMahon AD, et al. Adherenceto insulin treatment, glycaemic control, and ketoacidosisin insulin-dependent diabetes mellitus. TheDARTS/MEMO Collaboration. Diabetes Audit and Re-search in Tayside Scotland. Medicines Monitoring Unit.Lancet 1997: 350: 1505–510. 34. Hanas R, Lindgren F, Lindblad BA. 2-year national po-pulation study of pediatric ketoacidosis in Sweden: pre-disposing conditions and insulin pump use. Pediatr Dia-betes 2009: 10: 33–37. 35. Cope JU, Morrison AE, Samuels-Reid J. Adolescent use ofinsulin and patient-controlled analgesia pump technology:a 10-year Food and Drug Administration retrospectivestudy of adverse events. Pediatrics 2008: 121: e1133–e1138. 36.Dunger DB, Sperling MA, Acerini CL, et al. ESPE/LWPESconsensus statement on diabetic ketoacidosis in children andadolescents. Arch Dis Child 2004: 89: 188–94. 37. Monroe KW, King W, Atchison JA. Use of PRISM sco-res in triage of pediatric patients with diabetic ketoacido-sis. Am J Manag Care 1997: 3: 253–58. 38. Bonadio WA, Gutzeit MF, Losek JD, Smith DS. Outpa-tient management of diabetic ketoacidosis. Am J Dis Child1988: 142: 448–50. 39. Linares MY, Schunk JE, Lindsay R. Laboratory presen-tation in diabetic ketoacidosis and duration of therapy. Pe-diatr Emerg Care 1996: 12: 347–51. 40. Malik FS, Taplin CE. Insulin therapy in children and adoles-cents with type 1 diabetes. Pediatr Drugs 2014; 16: 141-50. 41. American Diabetes Association. Standards of medical carein diabetes---2014. Diabetes Care 2014; 37 (Suppl 1): 14-80. 42. Vurallı D, Kandemir N. Tip 1 Diabetes Mellitus. ÇocukEndokrinolojisi; Editörler: Cinaz, Darendeliler, Akıncı, veark., 2014; 15 (2): 399-452.
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm makale
Yazarlar

Uzm. Dr. Ahmet Uçar Bu kişi benim

Yayımlanma Tarihi 8 Kasım 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 8 Sayı: 6

Kaynak Göster

APA Uçar, U. D. A. (2016). Çocukluk Çağında Tip 1 Diyabet. Klinik Tıp Pediatri Dergisi, 8(6), 22-32.
AMA Uçar UDA. Çocukluk Çağında Tip 1 Diyabet. Pediatri. Kasım 2016;8(6):22-32.
Chicago Uçar, Uzm. Dr. Ahmet. “Çocukluk Çağında Tip 1 Diyabet”. Klinik Tıp Pediatri Dergisi 8, sy. 6 (Kasım 2016): 22-32.
EndNote Uçar UDA (01 Kasım 2016) Çocukluk Çağında Tip 1 Diyabet. Klinik Tıp Pediatri Dergisi 8 6 22–32.
IEEE U. D. A. Uçar, “Çocukluk Çağında Tip 1 Diyabet”, Pediatri, c. 8, sy. 6, ss. 22–32, 2016.
ISNAD Uçar, Uzm. Dr. Ahmet. “Çocukluk Çağında Tip 1 Diyabet”. Klinik Tıp Pediatri Dergisi 8/6 (Kasım 2016), 22-32.
JAMA Uçar UDA. Çocukluk Çağında Tip 1 Diyabet. Pediatri. 2016;8:22–32.
MLA Uçar, Uzm. Dr. Ahmet. “Çocukluk Çağında Tip 1 Diyabet”. Klinik Tıp Pediatri Dergisi, c. 8, sy. 6, 2016, ss. 22-32.
Vancouver Uçar UDA. Çocukluk Çağında Tip 1 Diyabet. Pediatri. 2016;8(6):22-3.