Glycemic Controls of Patients with Type 1 Diabetes, Affecting Factors and Relationship Between Type 1 Diabetes and Infection Frequency

Öz

Objective: Type 1 diabetes mellitus (Type 1 DM) is the most common endocrine-metabolic disorder at childhood and adolescence. In this study, it was aimed to determine the risk factors for poor metabolic control in Type 1 DM, the frequency of infection in the cases, the frequency of accompanying autoimmune diseases, the effect of Type 1 DM on the final height and body mass index (BMI) and to review the treatment and follow-up.

Material and Methods: The present study included 184 children and adolescent with Type 1 DM. The patient charts were retrospectively reviewed and a questionnaire was applied including sociodemographic characteristics of the patients, and history of infection.

Results: Of the cases included, 53.5% were girl whereas 46.7% were boy with a mean age of 12.71±0.31 years. Mean age at diagnosis was 7.71±0.29 years while mean Hb1ac value was 8.45±1.78. No correlation was found between mean HbA1c value and family history for diabetes mellitus, household size, residency and monthly income. Since type 1 DM is a chronic disease, the final dye effect in patients was made by comparing the target height with the final height. It was observed that 29 patients who reached to final height passed over their target height. It was determined that as the mean HbA1c value, which is an indicator of metabolic control, increased, microalbuminuria and neuropathy increased. There was no severe infection requiring hospitalization. The mean number of infection per year was 2.3 and there was no increase in the frequency of infection.

Conclusion: In conclusion, duration of disease and increased age, puberty, socioeconomic status, incompliance to dietary recommendation and failure in attending control visits were identified as risk factor for poor metabolic control in patients with Type 1 DM. It was found that patients reached to target height by improved metabolic control. No increase in infection rate or severe infection requiring hospitalization was observed in our patients. The frequency of autoimmune diseases was similar to the literature.

Anahtar Kelimeler

• Hemoglobin A1C
• Infection
• Metabolic
• Type 1 Diabetes Mellitus

Tip 1 Diyabet Hastalarının Glisemik Kontrolleri, Etkileyen Faktörler ve Tip 1 Diyabet ile Enfeksiyon Sıklığı İlişkisi

Öz

Amaç: Tip 1 diabetes mellitus (Tip 1 DM), çocukluk ve ergenlikte en sık görülen endokrin-metabolik bozukluktur. Bu çalışmada, Tip 1 DM’de kötü metabolik kontrol için risk faktörleri, olgularda enfeksiyon sıklığı, eşlik eden otoimmün hastalık sıklığı, Tip 1 DM’un final boyuna ve vücut kitle indeksine (VKİ) etkisinin saptanması planlanarak tedavi ve izlemlerinin tekrar gözden geçirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Bu çalışmaya Tip 1 DM’li 184 çocuk ve ergen dahil edilmiştir. Hasta dosyaları retrospektif olarak incelenmiştir ve hastaların sosyodemografik özelliklerini ve enfeksiyon öyküsünü içeren bir anket uygulanmıştır.

Bulgular: Dahil edilen vakaların% 53.5’i kız,% 46.7’si erkek olup yaş ortalaması 12.71±0.31 yıldı. Ortalama tanı yaşı 7.71±0.29 yıl iken ortalama Hb1ac değeri 8.45±1.78’di. Ortalama HbA1c değeri ile tip 1 DM için aile öyküsü, ev halkı büyüklüğü, ikametgah ve aylık gelir arasında bir korelasyon bulunmadı. Tip 1 DM kronik bir hastalık olması nedeni ile hastalarda nihai boya etkisi, hedef boy ile nihai boy karşılaştırılarak yapıldı. Nihai boya ulaşan 29 hastanın hedef boylarını geçtiği görüldü. Metabolik kontrolün bir göstergesi olan ortalama HbA1c değeri arttıkça mikroalbüminüri ve nöropatinin arttığı saptandı. Olgularda hastanede yatış gerektirecek ciddi enfeksiyon olmadığı ve yıllık ortalama enfeksiyon sayısı 2,3 olduğu görüldü. Enfeksiyon sıklığında artış saptanmadı.

Sonuç: Sonuç olarak, Tip 1 DM’li hastalarda kötü metabolik kontrol için risk faktörü olarak hastalık süresi ve artmış yaş, ergenlik, sosyoekonomik durum, diyet önerilerine uyumsuzluk ve kontrol ziyaretlerine gelememe tespit edilmiştir. Geliştirilmiş metabolik kontrol ile hastaların hedef boya ulaştığı görülmüştür. Hastalarımızda enfeksiyon oranında artış veya hastanede yatmayı gerektirecek ciddi enfeksiyon görülmemiştir. Literatür ile benzer otoimmün hastalık sıklığı izlenmiştir.

Anahtar Kelimeler

• Tip 1 diyabetes mellitus
• metabolik kontrol
• demografik özellikler
• enfeksiyon sıklığı

Kaynakça

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