Background. Impairment of the central nervous system manifested as cognitive dysfunction caused by metabolic or structural changes is a severe progressive vascular complication of type 1 diabetes mellitus (T1DM). Significant difficulties in the diagnosis of cognitive dysfunction are associated with subjective diagnostic techniques. Objective. To identify the role of neurospecific markers in the diagnosis of cognitive dysfunction in patients with T1DM. Materials and Methods. A total of 58 patients with T1DM aged 16?30 years were included in this study. The control group included 29 healthy young adults matched by gender and age. The survey included clinical and laboratory examinations, psychological testing and magnetic resonance imaging (MRI) of the brain. The Montreal Cognitive Assessment (MoCA) was used to screen for cognitive impairment. The levels of neurospecific proteins (S100, glial fibrillary acidic protein and myelin basic protein) were determined to identify early markers of cognitive impairment. MRI of the brain was performed using a Siemens Magnetom 1.0 T system to assess structural changes in the central nervous system. Results. The study revealed increased levels of all neurospecific proteins, which correlated with parameters of hyperglycaemia and cognitive deficit (MoCA scores of
BACKGROUND: According to research, only 38% of patients reach glycated hemoglobin targets. It is possible to improve the effectiveness of medical care for children with T1D using modern technologies, including continuous glucose monitoring (CGM).
AIMS: To evaluate the effectiveness of outpatient monitoring of children and adolescents with T1D with regular use of professional continuous glucose monitoring.
METHODS: The inclusion criteria: age 812 years; T1D at least 1 year; insulin therapy by multiple injections of insulin; inadequate glycemic control of T1D: НbА1с level of 7.5% and higher and / or children and adolescents with frequent episodes of hypoglycemia (usually 4 times a week) or with a history of severe hypoglycemia; signed informed consent. All patients initially and 12 weeks after inclusion in the study conducted a study of the level of НbА1с, and also performed CGM for 6 days. Based on the results of CGM, glycemia indicators and daily doses of insulin were recorded, treatment was evaluated and corrected, and recommendations for self-monitoring were made. Glucose monitoring was carried 120144 hours using the blind method iPro2 (Medtronic, USA).
RESULTS: In all, 99 children aged 818 years were included in the study in all centers. The decrease in the level of НbА1с by the end of the study was 0.72%, while the proportion of patients who reached the target level of НbА1с (defined as 7.5%) was statistically significantly higher at the end of the study (15.5% and 2%, respectively; p0.05). During the study, patients showed a trend towards a decrease in the average level and variability of glycemia by the end of the study, however, statistical significance was achieved only in relation to the average level of glycemia (p=0.04). Conducted insulin therapy, determined by the average daily doses of long-acting and short-acting insulin, did not statistically significantly change at the end of the study. The frequency of DKA episodes and severe hypoglycemia did not statistically significantly differ from the initial level.
CONCLUSIONS: For children with poor glycemic control of T1D, the use of professional CGM is effective in terms of glycemic control and a safe method.
Сахарный диабет (СД) 1-го типа считается метаболическим расстройством, приводящим к многофакторному отрицательному воздействию на органы-мишени, одновременно является важным фактором риска в развитии когнитивных нарушений, проблема профилактики и лечения которых в настоящее время занимает одно из центральных мест в современной эндокринологии и неврологии. Цель исследования-оценить современные методики реабилитации в коррекции когнитивных нарушений у пациентов с СД 1-го типа. Были обследованы 50 пациентов с СД 1-го типа в возрасте от 18 до 45 лет, всем пациентам измеряли уровни гликемии натощак, гликированного гемоглобина (HbA1c). Проведена рандомизация: пациенты 1-й группы проходили когнитивный тренинг с использованием компьютеризированной программы Happy Neuron Pro 2 раза в неделю по 45 минут; 2-я группа занималась лечебной физкультурой на базе спортивно-оздоровительного комплекса ФГБОУ ВО СибГМУ 2 раза в неделю по 60 минут. При оценке уровня HbA1c было отмечено его большее снижение в 1-й группе по сравнению со 2-й группой (0,7% и 0,3% соответственно). Когнитивные функции улучшились в обеих группах реабилитации в среднем на 2 балла. Использование методик двигательной и компьютерной реабилитации улучшает когнитивные функции у пациентов с СД 1-го типа. Использование компьютеризированного тренинга приводит к значимому улучшению показателей углеводного обмена. Ключевые слова: современные технологии, когнитивная реабилитация, сахарный диабет 1-го типа
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.