Šećerna bolest u djece i adolescenata

master's thesis

• Title (english): Diabetes mellitus in children and adolescents
• Author: Sandra Židak
• Mentor: Roberta Petlevski (mentor)
• Committee member: Roberta Petlevski (predsjednik povjerenstva)
• Committee member: Marija Grdić Rajković (član povjerenstva)
• Committee member: Lovorka Vujić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of medical biochemistry and haematology); Zagreb
• Defense date and country: 2019-09-26, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Šećerna bolest je skupina metaboliĉkih poremećaja karakteriziranih kroničnom hiperglikemijom koja nastaje zbog poremećenog lučenja inzulina i/ili poremećenog inzulinskog djelovanja. Šećerna bolest tipa 1 najčešći je oblik dijabetesa u djece i adolescenata, a u posljednjih desetak godina incidencija se povećava 2-5% godišnje. S pandemijom pretilosti svjedočimo sve većoj učestalosti i šećerne bolesti tipa 2 već u toj dobi. Procjenjuje se da se danas dijabetes melitus tip 2 pojavljuje u jednom od tri novodijagnosticiranih dijabetesa kod djece. Šećerna bolest tipa 1 karakterizirana je apsolutnim nedostatkom inzulina koji je u dječjoj i adolescentnoj dobi obično uvjetovan autoimunim razaranjem β-stanica Langerhansovih otočića gušterače. Šećerna bolest tipa 2 ima multifaktorsku etiologiju, uključujući pretilost povezanu s genetskim, okolišnim faktorima te načinom života. Karakterizira ju hiperglikemija koja nastaje kao posljedica smanjene inzulinske sekrecije uz prethodnu inzulinsku rezistenciju. Debljina je značajan čimbenik rizika za razvoj, tijek i liječenje šećerne bolesti tipa 2 kako u odraslih, tako i u djece i adolescenata. Važno ju je prevenirati i liječiti jer njezine posljedice znatno utječu na povišenje morbiditeta pojedinca. Najčešći mehanizam njenog nastanka je nerazmjer između energijskog unosa hranom i potrošnje energije u organizmu. Pubertet ima ulogu u razvoju dijabetesa melitusa tipa 2 u djece ponajprije zbog pogoršanja inzulinske rezistencije u tom razdoblju života uzrokovanog promjenom hormonske homeostaze, prvenstveno hipersekrecijom hormona rasta. Dijagnoza dijabetesa, prema kriterijima WHO-a, postavlja se mjerenjem glukoze u venskoj plazmi u akreditiranom laboratoriju. Zbrinjavanje osoba s dijabetesom multidisciplinaran je timski rad u kojem je najvaţnije aktivno uključivanje bolesnika u liječenje i samokontrolu. Temelj svakog liječenja šećerne bolesti je zdrava prehrana, tjelovježba i zdrav način ţivota za što je potrebna kontinuirana edukacija pacijenta. Dijabetes tipa 1 se obiĉno i u djece i odraslih liječi inzulinom, dok se tip 2 liječi metforminom. Postoje i druge skupine lijekova koji se procjenjuju zbog njihove sigurnosti i djelotvornosti u odnosu na pedijatrijske bolesnike. Pogoršanje metaboličke kontrole u djece s dijabetesom posebno izraženo tijekom adolescencije ĉini ih podložnima za razvoj i akutnih i kroničnih komplikacija bolesti. Psihosocijalni problemi su vrlo česti kod djece s dijabetesom i njihovih obitelji. Iako preventivne mjere razvoja tipa 1 još uvijek nisu poznate, uspješna prevencija šećerne bolesti tipa 2 je moguća. Prevencija i liječenje pretilosti te šećerne bolesti tipa 2 trebali bi postati jedan od glavnih ciljeva javnih intervencijskih programa.

Abstract (english)

Diabetes mellitus is a group of metabolic diseases characterized by high blood glucose levels resulting from defects in insulin secretion, insulin action, or both. Type 1 diabetes is the most common form of diabetes in children and adolescents, and in the last ten years the incidence has increased by 2-5% per year. Due to a pandemic spread of obesity, there is a growing incidence of type 2 diabetes mellitus even in this age group. Type 2 diabetes mellitus is estimated to occur in one in three of new diagnoses of diabetes in children today. Type 1 diabetes is characterized by the absolute insulin deficiency that is usually caused by autoimmune destruction of pancreatic islet β-cells. Type 2 diabetes has a multifactorial etiology, including obesity associated with genetic, environmental factors and lifestyle. It is characterized by hyperglycaemia resulting from reduced insulin secretion with prior insulin resistance. Obesity is a significant risk factor for the development, course, and treatment of type 2 diabetes in both adults and youth. It is important to prevent and treat obesity because its consequences significantly affect the increase of the individual's morbidity. Most common mechanism for its onset is the disparity between food energy intake and energy consumption in the body. Puberty plays a role in the development of type 2 diabetes mellitus in children primarily due to the worsening of insulin resistance during this period of life caused by a change in hormonal homeostasis, primarily hypersecretion of growth hormones. Diagnosis of diabetes, according to WHO criteria, is made by measuring glucose in venous plasma in an accredited laboratory. Caring for people with diabetes is a multidisciplinary teamwork in which the active involvement of patients in treatment and self-control is most important. The basis for diabetes treatment is a healthy diet, exercise and a healthy lifestyle, which requires continued patient education. Usually, in both children and adults, T1D is treated with insulin while T2D is treated with metformin. There are other classes of drugs that are under assessment for their safety and efficacy in relation to pediatric patients. Impairment of metabolic control in children with diabetes especially pronounced during adolescence makes them susceptible to the development of both acute and chronic complications of the disease. Psychosocial problems are very common in children with diabetes and their families. Although preventive measures of type 1 development are still unknown, successful prevention of type 2 diabetes is possible. Prevention and treatment of obesity and type 2 diabetes should become one of the main goals of public intervention programs.

• Keywords: šećerna bolest; dijabetes; pretilost; djeca; adolescenti; liječenje; hipoglikemija
• Keywords (english): Diabetes mellitus; obesity; children; adolescents; treatment; hypoglycemia
• Language: croatian
• URN:NBN: urn:nbn:hr:163:237620
• Study programme: Title: Medical biochemistry; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra medicinske biokemije (magistar/magistra medicinske biokemije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-03-04 16:47:26