Clinical Research
BibTex RIS Cite

Tip 1 Diabetes Mellitus’lu Çocuk ve Adolesan Hastaların Retrospektif Olarak Değerlendirilmesi: Tek Merkez Deneyimi

Year 2021, Volume: 15 Issue: 2, 142 - 149, 30.03.2021
https://doi.org/10.12956/tchd.845703

Abstract

Amaç: Tip 1 diabetes mellitus(DM), çocukluk çağı ve adolesan dönemde en sık görülen kronik endokrin hastalıklardan birisidir. Diyabetli çocuğun izlemi sırasında amaç; ketoasidoz ve hipoglisemi ataklarının oluşumunu engellemek, hastaların normal büyüme-gelişmesini sağlamak ve kronik komplikasyonların gelişimini önlemektir. Tüm bunları yaparken de çocuğun ruh sağlığının korunması sağlanmalıdır. Bu çalışmada, kliniğimizde takip edilen Tip 1 DM’li çocuk ve adolesan hastaların hastane dosyalarını geriye dönük olarak olarak inceleyerek mevcut durumlarını değerlendirmeyi ve gelişen kronik komplikasyonları tespit etmeyi amaçladık.


Gereç ve Yöntemler
: Bu çalışma, Sağlık Bakanlığı Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim ve Araştırma Hastanesi, Pediyatrik Endokrinoloji pokliniğinde en az 1 yıllık takibi olan tip 1 DM tanılı olgular ile yapılmıştır. Olguların dosyaları geriye dönük olarak incelendi; fizik muayene bulguları, cinsiyet, yaş, diyabet tanısı konulan yaş , diyabet süresi, kullandıkları insülin miktarı (Ü/kg), kullandıkları insülin rejimi, kan lipid düzeyleri, son bir yıllık HbA1c değerleri, eşlik eden otoimmün hastalıklar ve son retinopati kontrolleri kaydedilmiştir. HbA1c % 6.5-7.5: İyi kontrollü diyabet, HbA1c % 7.6-9: Orta kontrollü diyabet, HbA1c > %9: Kötü kontrollü diyabet olarak kabul edilmiştir. Nefropati değerlendirmesi için mevcut olan olguların, 24 saatlik idrar ve 24 saatlik tansiyon monitorizasyonu sonuçları kaydedilmiştir.

Bulgular: Çalışmaya alınan 204 olgunun 112’si kız, 92’si erkekti. Hastaların yaş ortalaması 13.1 ± 3.82 yıl, diyabet tanısı aldıkları yaş ortalaması 7.66 ± 3.81 yıl, ortalama hastalık süreleri 5.52 ± 3.37 yıldı. Kullanılan insülin miktarının yaşla birlikte arttığı ancak yaş grupları arasında istatistiksel olarak anlamlı bir fark olmadığı bulundu. Çalışmaya dahil edilen hastaların HbA1c değerleri % 5.6-14.75 arasında, ortalama % 8.52 ± 1.49’dı. 10 yaşından küçük hastaların HbA1c düzeyi hem 10-15 yaş grubundan (p = 0.002) hem de 15 yaş üstü gruptan (p = 0.008) daha düşük bulundu. 5 yıldan az süren diyabetik olan hastalarda HbA1c düzeyi, hem 5-10 yıl süredir diyabetik gruptan (p = 0.004) hem de 10 yıldan uzun süredir diyabetik olan gruptan (p = 0.018) anlamlı olarak daha düşük bulundu. Tip 1 diyabetli olgulara en sık eşlik eden otoimmün hastalıklar otoimmün tiroid hastalığı (%13.7) ve çölyak hastalığı (% 4.9) olarak bulundu. Retinopati saptanan olgu yoktu. Yüz kırk altı olguda, 24 saatlik idrar toplandı ve glomeruler filtrasyon hızı(GFH) hesaplandı. Bu olguların % 29.5’inde GFH yüksek saptandı. Glomeruler filtrasyon hızı yüksekliği olan hastalar Evre 1 diyabetik nefropati olarak değerlendirildi. Yüz kırk altı olguda mikroalbumin düzeyleri incelendi ve %29.5’inde mikroalbuminüri saptandı. Diyabet süreleri ile GFH ve mikroalbuminüri arasında istatistiksel olarak anlamlı fark yoktu. Hastalık kontrolüne göre yaşam içinde kan basıncı izleme(YİKBİ) parametreleri değerlendirildiğinde iyi–orta kontrol grubu ile kötü kontrol grubu arasında hipertansiyon açısından istatiksel olarak anlamlı fark görülmedi.

Sonuç: 10 yaşın üzerindeki hastalarda HbA1c değerlerinin yüksek olması, diyabetik adolesan hastaların yönetiminin daha dikkatli yapılması gerektiğini düşündürmektedir. Glomeruler filtrasyon hızı hesaplanan grupta yüksek oranda evre 1 nefropati tespit edilmiş olması diyabetik nefropatinin erken tanınması ve tedavisinin planlanması için hastaların 24 saatlik idrar analizi ile taranmasının önemini göstermiştir. Hastalarımızın % 89.2’nin orta-kötü kontrol grubunda olması takiplerimizin daha titizlikle yapılması gerektiğini, bu hastaların kan lipid düzeylerindeki yüksekliğinin kardiyovasküler hastalıklar açısından önemli risk faktörü olduğu akılda tutulmalıdır. Diyabet izlemi titizlikle ve deneyimli bir ekiple yapılmalıdır. Gelişebilecek komplikasyonların büyük bir bölümü, iyi bir izlemle önlenebilen durumlardır. İyi bir izlem çocuğun fiziksel ve ruhsal olarak sağlıklı bir birey olmasını sağlayacaktır.

References

  • Mayer-Davis EJ, Kahkoska AR, Jefferies C, Dabelea D, Balde N, Gong CX, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes 2018; 27(Suppl 27):7-19.
  • Insel RA, Dunne JL, Atkinson MA, Chiang JL, Dabelea D, Gottlieb PA, et al. Staging presymptomatic type 1 diabetes: a scientific statement of JDRF, the Endocrine Society, and the American Diabetes Association. Diabetes Care 2015;38:1964-74.
  • IDF Diabetes Atlas. 8th ed. Brussels, Belgium: International Diabetes Federation; 2017.IDF. Erişim Tarihi: 14/11/2017. Available from:https://www.diabetesatlas.org/
  • Watkins RA, Evans-Molina C, Blum JS, DiMeglio LA. Established and emerging biomarkers for the prediction of type 1 diabetes: a systematic review. Transl Res 2014;164:110-21.
  • Neyzi O, Bundak R, Gokcay G, Gunoz H, Furman A, Darendeliler F, et al. Reference values for weight, height, head circumference, and body mass index in Turkish Children. J Clin Res Pediatr Endocrinol 2015;7:280–93.
  • Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in girls. Arch Dis Child 1969;44:291-303.
  • Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child 1970;45:13-23.
  • Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, et al. American Diabetes Association. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 2005;28:186-212.
  • Hogg RJ, Furth S, Lemley KV, Portman R, Schwartz GJ, Coresh J, et al. National Kidney Foundation's Kidney Disease Outcomes Quality Initiative. National Kidney Foundation's Kidney Disease Outcomes Quality Initiative clinical practice guidelines for chronic kidney disease in children and adolescents: evaluation, classification, and stratification. Pediatrics 2003;111:1416-21.
  • Wühl E, Witte K, Soergel M, Mehls O, Schaefer F; German Working Group on Pediatric Hypertension. Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. J Hypertens 2002;20:1995-2007.
  • Şimşek E, Karabay M, Kocabey K. Batı Karadeniz Bölgesinde yaşayan çocuklarda insüline bağımlı diyabetes mellitusun epidemiyolojik özellikleri. Türk Pediatri Arşivi 2003;38: 216-22.
  • Karadağ A, Çelik Y, Toklucu MÖ, Hasbal C, Hatipoğlu S. Bakırköy Dr.Sadi Konuk Eğitim ve Araştırma HastanesiÇocuk sağlığı ve Hastalıkları kliniğinde izlenen tip 1 diyabetes mellituslu çocukların epidemiyolojik özellikleri. ŞEH Tıp Bülteni 2008;42: 17-21.
  • Kandemir N, Açıkgöz E, Yordan N. The Epidemiology of Diabet Onset İnsulin Dependent Diabetes Mellitus in Turkish Children: A Retrospektive Analysis of 477 Cases. Turk J Pediatr 1994; 36: 191-5.
  • Derraik JG, Reed PW, Jefferies C, Cutfield SW, Hofman PL, Cutfield WS. Increasing incidence and age at diagnosis among children with type 1 diabetes mellitus over a 20-year period in Auckland (New Zealand). PLoS One 2012;7:e32640.
  • Mahmud FH, Elbarbary NS, Fröhlich-Reiterer E, Holl RW, Kordonouri O, Knip M, Simmons K, Craig ME. ISPAD Clinical Practice Consensus Guidelines 2018: Other complications and associated conditions in children and adolescents with type 1 diabetes. Pediatr Diabetes 2018;19 Suppl 27:275-86.
  • Hughes JW, Riddlesworth TD, DiMeglio LA, Miller KM, Rickels MR, McGill JB. Autoimmune Diseases in Children and Adults With Type 1 Diabetes From the T1D Exchange Clinic Registry. J Clin Endocrinol Metab 2016 Dec;101:4931-7.
  • 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.
  • DiMeglio LA, Acerini CL, Codner E, Craig ME, Hofer SE, Pillay K, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Glycemic control targets and glucose monitoring for children, adolescents, and young adults with diabetes. Pediatr Diabetes 2018;19 Suppl 27:105-14.
  • Springer D, Dziura J, Tamborlane WV, Steffen AT, Ahern JH, Vincent M, et al. Optimal control of type 1 diabetes mellitus in youth receiving intensive treatment. J Pediatr 2006;149:227-32.
  • Imkampe AK, Gulliford MC. Trends in Type 1 diabetes incidence in the UK in 0- to 14-year-olds and in 15- to 34-year-olds, 1991-2008. Diabet Med 2011; 28:811-4.
  • Danne T, Phillip M, Buckingham BA, Jarosz-Chobot P, Saboo B, Urakami T, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Insulin treatment in children and adolescents with diabetes. Pediatr Diabetes 2018;19 Suppl 27:115-35.
  • Mortensen HB, Robertson KJ, Aanstoot HJ, Danne T, Holl RW, Hougaard P, et al. Insulin management and metabolic control of type 1 diabetes mellitus in childhood and adolescence in 18 countries. Hvidøre Study Group on Childhood Diabetes. Diabet Med 1998;15:752-9.
  • Diabetes Control and Complications Trial Research Group, Nathan DM, Genuth S, Lachin J, Cleary P, Crofford O, Davis M, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977-86.
  • Battaglia M, Anderson MS, Buckner JH, Geyer SM, Gottlieb PA, Kay TWH, et al. Understanding and preventing type 1 diabetes through the unique working model of TrialNet. Diabetologia 2017;60:2139-47.
  • Amin R, Widmer B, Prevost AT, Schwarze P, Cooper J, Edge J, et al. Risk of microalbuminuria and progression to macroalbuminuria in a cohort with childhood onset type 1 diabetes: prospective observational study. BMJ 2008;336:697-701.
  • Krolewski AS. Progressive renal decline: the new paradigm of diabetic nephropathy in type 1 diabetes. Diabetes Care 2015;38:954-62.
  • Rudberg S, Persson B, Dahlquist G. Increased glomerular filtration rate as a predictor of diabetic nephropathy an 8-year prospective study. Kidney Int 1992;41:822-8.
  • Lurbe E, Sorof JM, Daniels SR. Clinical and research aspects of ambulatory blood pressure monitoring in children. J Pediatr 2004;144:7-16.
  • Lurbe E, Redon J, Kesani A, Pascual JM, Tacons J, Alvarez V, et al. Increase in nocturnal blood pressure and progression to microalbuminuria in type 1 diabetes. N Engl J Med 2002;347:797-805.
  • Bogdanović R. Diabetic nephropathy in children and adolescents. Pediatr Nephrol 2008;23:507-25.
  • Chiarelli F, Trotta D, Verotti A, Mohn A.Treatment of hypertension an microalbuminuria in children and adolescents with type 1 diyabetes mellitus. Pediatric diabetes 2002:3: 113-24.
  • Levitsky L L, Misra M, Wolfsdorf J I, Hoppin A G.Complications and screening in children and adolescents with type 1 diabetes mellitus. Erişim tarihi: 2009. Avalible from: http://www.uptodate.com
  • Maahs DM, Maniatis AK, Nadeau K, Wadwa RP, McFann K, Klingensmith GJ. Total cholesterol and high-density lipoprotein levels in pediatric subjects with type 1 diabetes mellitus. J Pediatr 2005;147:544-6.
  • Abraha A, Schultz C, Konopelska-Bahu T, James T, Watts A, Stratton IM, et al. Glycaemic control and familial factors determine hyperlipidaemia in early childhood diabetes. Oxford Regional Prospective Study of Childhood Diabetes. Diabet Med 1999;16:598-604.
  • Maahs DM, Wadwa RP, McFann K, Nadeau K, Williams MR, Eckel RH, et al. Longitudinal lipid screening and use of lipid-lowering medications in pediatric type 1 diabetes. J Pediatr 2007;150:146-50.
  • Caramori ML, Fioretto P, Mauer M. Enhancing the predictive value of urinary albumin for diabetic nephropathy. J Am Soc Nephrol 2006;17:339-52.
  • Jenkins AJ, Lyons TJ, Zheng D, Otvos JD, Lackland DT, McGee D, et al. DCCT/EDIC Research Group. Lipoproteins in the DCCT/EDIC cohort: associations with diabetic nephropathy. Kidney Int 2003;64:817-28.
  • Coonrod BA, Ellis D, Becker DJ, Bunker CH, Kelsey SF, Lloyd CE, et al. Predictors of microalbuminuria in individuals with IDDM. Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes Care 1993;16:1376-83.

Retrospective Evaluation of Type 1 Diabetes Mellitus Children and Adolescent Patients: A Single Center Experience

Year 2021, Volume: 15 Issue: 2, 142 - 149, 30.03.2021
https://doi.org/10.12956/tchd.845703

Abstract

Objective: Type 1 diabetes mellitus (DM) is one of the most common chronic endocrine diseases in childhood and adolescence. Preventing ketoacidosis and hypoglycemia attacks, ensuring normal growth and development, preventing chronic complication occurrence are the aims of diabetic child follow-up. While doing all these, the mental health of the child should be protected. In this study, we aimed to evaluate the status of pediatric and adolescent patients with Type 1 DM followed up in our clinic and to identify the chronic complications retrospectively by examining the hospital records.

Material and Methods: This study was carried out with cases with type 1 DM who had been followed up for at least 1 year in the pediatric endocrinology clinic of the Ministry of Health, Ankara Pediatric Health and Diseases Hematology Oncology Training and Research Hospital. The files of the cases were analysed retrospectively; physical examination findings, gender, age, diabetes diagnosis age, duration of diabetes, insulin regimen and the amount of insulin usage (U / kg), blood lipid levels, HbA1c values of the last year, accompanying autoimmune diseases and recent retinopathy controls were recorded. HbA1c percentages are classified as follows; 6.5-7.5%: Well controlled diabetes, 7.6-9%: Moderately controlled diabetes and HbA1c> 9%: Poorly controlled diabetes. For nephropathy evaluation, the 24-hour urine and 24-hour blood pressure monitoring results of the available cases were recorded.

Results: Of the 204 patients included in the study, 112 were female and 92 were male. The mean age of the patients was 13.1 ± 3.82 years, the mean age at which they were diagnosed with diabetes was 7.66 ± 3.81 years, and the mean duration of the disease was 5.52 ± 3.37 years. It was found that the amount of insulin used increased with age but it was not a statistically significant difference between the age groups. The HbA1c values of the patients included in the study were between 5.6-14.75%, and the average was 8.52 ± 1.49%. The HbA1c level in patients younger than 10 years old was lower than both 10-15 year-old group (p = 0.002), and patients older than 15 year-old group (p = 0.008). The HbA1c level in patients with diabetes lasting less than 5 years was found to be lower than both the group with diabetes lasting for 5-10 years (p = 0.004) and the group with diabetes lasting more than 10 years (p = 0.018 ). The most common autoimmune diseases accompanying patients with type 1 diabetes were autoimmune thyroid disease (13.7%) and celiac disease (4.9%). There were no cases with retinopathy. In 146 cases, 24-hour urine was collected and the glomerular filtration rate (GFR) was calculated. Glomerular filtration rate was found to be high in 29.5% of these cases. Patients with high glomerular filtration rate were evaluated as Stage 1 diabetic nephropathy. Microalbumin levels were examined in 146 cases, and microalbuminuria was detected in 29.5%. There was no statistically significant difference between diabetes duration both GFR and microalbuminuria.There was no statistically significant difference of ambulatory blood-pressure monitoring (ABPM) parameter between the good-moderate control group and the poor control group.


Conclusion:
Because of high HbA1c levels in patients older than 10 years, the management of diabetic adolescent patients should be done more careful. The high percentage of stage 1 nephropathy detected in the group whose glomerular filtration rate was calculated showed the importance of screening patients with 24-hour urine analysis for early diagnosis and treatment of diabetic nephropathy. It should be kept in mind that 89.2% of our patients are in the middle-poor control group, and our follow-ups should be done more meticulously, and the high blood lipid levels of these patients is an important risk factor for cardiovascular diseases. Diabetes monitoring should be done meticulously and with an experienced team. Most of the complications that may develop are conditions that can be prevented with a good follow-up. A good follow-up will ensure that the child becomes a physically and mentally healthy individual.

References

  • Mayer-Davis EJ, Kahkoska AR, Jefferies C, Dabelea D, Balde N, Gong CX, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes 2018; 27(Suppl 27):7-19.
  • Insel RA, Dunne JL, Atkinson MA, Chiang JL, Dabelea D, Gottlieb PA, et al. Staging presymptomatic type 1 diabetes: a scientific statement of JDRF, the Endocrine Society, and the American Diabetes Association. Diabetes Care 2015;38:1964-74.
  • IDF Diabetes Atlas. 8th ed. Brussels, Belgium: International Diabetes Federation; 2017.IDF. Erişim Tarihi: 14/11/2017. Available from:https://www.diabetesatlas.org/
  • Watkins RA, Evans-Molina C, Blum JS, DiMeglio LA. Established and emerging biomarkers for the prediction of type 1 diabetes: a systematic review. Transl Res 2014;164:110-21.
  • Neyzi O, Bundak R, Gokcay G, Gunoz H, Furman A, Darendeliler F, et al. Reference values for weight, height, head circumference, and body mass index in Turkish Children. J Clin Res Pediatr Endocrinol 2015;7:280–93.
  • Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in girls. Arch Dis Child 1969;44:291-303.
  • Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child 1970;45:13-23.
  • Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, et al. American Diabetes Association. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 2005;28:186-212.
  • Hogg RJ, Furth S, Lemley KV, Portman R, Schwartz GJ, Coresh J, et al. National Kidney Foundation's Kidney Disease Outcomes Quality Initiative. National Kidney Foundation's Kidney Disease Outcomes Quality Initiative clinical practice guidelines for chronic kidney disease in children and adolescents: evaluation, classification, and stratification. Pediatrics 2003;111:1416-21.
  • Wühl E, Witte K, Soergel M, Mehls O, Schaefer F; German Working Group on Pediatric Hypertension. Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. J Hypertens 2002;20:1995-2007.
  • Şimşek E, Karabay M, Kocabey K. Batı Karadeniz Bölgesinde yaşayan çocuklarda insüline bağımlı diyabetes mellitusun epidemiyolojik özellikleri. Türk Pediatri Arşivi 2003;38: 216-22.
  • Karadağ A, Çelik Y, Toklucu MÖ, Hasbal C, Hatipoğlu S. Bakırköy Dr.Sadi Konuk Eğitim ve Araştırma HastanesiÇocuk sağlığı ve Hastalıkları kliniğinde izlenen tip 1 diyabetes mellituslu çocukların epidemiyolojik özellikleri. ŞEH Tıp Bülteni 2008;42: 17-21.
  • Kandemir N, Açıkgöz E, Yordan N. The Epidemiology of Diabet Onset İnsulin Dependent Diabetes Mellitus in Turkish Children: A Retrospektive Analysis of 477 Cases. Turk J Pediatr 1994; 36: 191-5.
  • Derraik JG, Reed PW, Jefferies C, Cutfield SW, Hofman PL, Cutfield WS. Increasing incidence and age at diagnosis among children with type 1 diabetes mellitus over a 20-year period in Auckland (New Zealand). PLoS One 2012;7:e32640.
  • Mahmud FH, Elbarbary NS, Fröhlich-Reiterer E, Holl RW, Kordonouri O, Knip M, Simmons K, Craig ME. ISPAD Clinical Practice Consensus Guidelines 2018: Other complications and associated conditions in children and adolescents with type 1 diabetes. Pediatr Diabetes 2018;19 Suppl 27:275-86.
  • Hughes JW, Riddlesworth TD, DiMeglio LA, Miller KM, Rickels MR, McGill JB. Autoimmune Diseases in Children and Adults With Type 1 Diabetes From the T1D Exchange Clinic Registry. J Clin Endocrinol Metab 2016 Dec;101:4931-7.
  • 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.
  • DiMeglio LA, Acerini CL, Codner E, Craig ME, Hofer SE, Pillay K, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Glycemic control targets and glucose monitoring for children, adolescents, and young adults with diabetes. Pediatr Diabetes 2018;19 Suppl 27:105-14.
  • Springer D, Dziura J, Tamborlane WV, Steffen AT, Ahern JH, Vincent M, et al. Optimal control of type 1 diabetes mellitus in youth receiving intensive treatment. J Pediatr 2006;149:227-32.
  • Imkampe AK, Gulliford MC. Trends in Type 1 diabetes incidence in the UK in 0- to 14-year-olds and in 15- to 34-year-olds, 1991-2008. Diabet Med 2011; 28:811-4.
  • Danne T, Phillip M, Buckingham BA, Jarosz-Chobot P, Saboo B, Urakami T, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Insulin treatment in children and adolescents with diabetes. Pediatr Diabetes 2018;19 Suppl 27:115-35.
  • Mortensen HB, Robertson KJ, Aanstoot HJ, Danne T, Holl RW, Hougaard P, et al. Insulin management and metabolic control of type 1 diabetes mellitus in childhood and adolescence in 18 countries. Hvidøre Study Group on Childhood Diabetes. Diabet Med 1998;15:752-9.
  • Diabetes Control and Complications Trial Research Group, Nathan DM, Genuth S, Lachin J, Cleary P, Crofford O, Davis M, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977-86.
  • Battaglia M, Anderson MS, Buckner JH, Geyer SM, Gottlieb PA, Kay TWH, et al. Understanding and preventing type 1 diabetes through the unique working model of TrialNet. Diabetologia 2017;60:2139-47.
  • Amin R, Widmer B, Prevost AT, Schwarze P, Cooper J, Edge J, et al. Risk of microalbuminuria and progression to macroalbuminuria in a cohort with childhood onset type 1 diabetes: prospective observational study. BMJ 2008;336:697-701.
  • Krolewski AS. Progressive renal decline: the new paradigm of diabetic nephropathy in type 1 diabetes. Diabetes Care 2015;38:954-62.
  • Rudberg S, Persson B, Dahlquist G. Increased glomerular filtration rate as a predictor of diabetic nephropathy an 8-year prospective study. Kidney Int 1992;41:822-8.
  • Lurbe E, Sorof JM, Daniels SR. Clinical and research aspects of ambulatory blood pressure monitoring in children. J Pediatr 2004;144:7-16.
  • Lurbe E, Redon J, Kesani A, Pascual JM, Tacons J, Alvarez V, et al. Increase in nocturnal blood pressure and progression to microalbuminuria in type 1 diabetes. N Engl J Med 2002;347:797-805.
  • Bogdanović R. Diabetic nephropathy in children and adolescents. Pediatr Nephrol 2008;23:507-25.
  • Chiarelli F, Trotta D, Verotti A, Mohn A.Treatment of hypertension an microalbuminuria in children and adolescents with type 1 diyabetes mellitus. Pediatric diabetes 2002:3: 113-24.
  • Levitsky L L, Misra M, Wolfsdorf J I, Hoppin A G.Complications and screening in children and adolescents with type 1 diabetes mellitus. Erişim tarihi: 2009. Avalible from: http://www.uptodate.com
  • Maahs DM, Maniatis AK, Nadeau K, Wadwa RP, McFann K, Klingensmith GJ. Total cholesterol and high-density lipoprotein levels in pediatric subjects with type 1 diabetes mellitus. J Pediatr 2005;147:544-6.
  • Abraha A, Schultz C, Konopelska-Bahu T, James T, Watts A, Stratton IM, et al. Glycaemic control and familial factors determine hyperlipidaemia in early childhood diabetes. Oxford Regional Prospective Study of Childhood Diabetes. Diabet Med 1999;16:598-604.
  • Maahs DM, Wadwa RP, McFann K, Nadeau K, Williams MR, Eckel RH, et al. Longitudinal lipid screening and use of lipid-lowering medications in pediatric type 1 diabetes. J Pediatr 2007;150:146-50.
  • Caramori ML, Fioretto P, Mauer M. Enhancing the predictive value of urinary albumin for diabetic nephropathy. J Am Soc Nephrol 2006;17:339-52.
  • Jenkins AJ, Lyons TJ, Zheng D, Otvos JD, Lackland DT, McGee D, et al. DCCT/EDIC Research Group. Lipoproteins in the DCCT/EDIC cohort: associations with diabetic nephropathy. Kidney Int 2003;64:817-28.
  • Coonrod BA, Ellis D, Becker DJ, Bunker CH, Kelsey SF, Lloyd CE, et al. Predictors of microalbuminuria in individuals with IDDM. Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes Care 1993;16:1376-83.
There are 38 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section ORIGINAL ARTICLES
Authors

Özlem Arman Bilir 0000-0001-8316-3603

Eda Mengen 0000-0003-1597-8418

Pınar Kocaay 0000-0003-0850-0360

Sadi Vidinlisan This is me 0000-0002-5113-2789

Publication Date March 30, 2021
Submission Date December 28, 2020
Published in Issue Year 2021 Volume: 15 Issue: 2

Cite

Vancouver Arman Bilir Ö, Mengen E, Kocaay P, Vidinlisan S. Tip 1 Diabetes Mellitus’lu Çocuk ve Adolesan Hastaların Retrospektif Olarak Değerlendirilmesi: Tek Merkez Deneyimi. Türkiye Çocuk Hast Derg. 2021;15(2):142-9.


The publication language of Turkish Journal of Pediatric Disease is English.


Manuscripts submitted to the Turkish Journal of Pediatric Disease will go through a double-blind peer-review process. Each submission will be reviewed by at least two external, independent peer reviewers who are experts in the field, in order to ensure an unbiased evaluation process. The editorial board will invite an external and independent editor to manage the evaluation processes of manuscripts submitted by editors or by the editorial board members of the journal. The Editor in Chief is the final authority in the decision-making process for all submissions. Articles accepted for publication in the Turkish Journal of Pediatrics are put in the order of publication, with at least 10 original articles in each issue, taking into account the acceptance dates. If the articles sent to the reviewers for evaluation are assessed as a senior for publication by the reviewers, the section editor and the editor considering all aspects (originality, high scientific quality and citation potential), it receives publication priority in addition to the articles assigned for the next issue.


The aim of the Turkish Journal of Pediatrics is to publish high-quality original research articles that will contribute to the international literature in the field of general pediatric health and diseases and its sub-branches. It also publishes editorial opinions, letters to the editor, reviews, case reports, book reviews, comments on previously published articles, meeting and conference proceedings, announcements, and biography. In addition to the field of child health and diseases, the journal also includes articles prepared in fields such as surgery, dentistry, public health, nutrition and dietetics, social services, human genetics, basic sciences, psychology, psychiatry, educational sciences, sociology and nursing, provided that they are related to this field. can be published.