The articles provide information and analysis of statistical indicators on the state of endocrinological care for children in 2020 in general in Ukraine and in some regions, their dynamics for 2014—2020. Providing data on staffing of the pediatric endocrinology service; the state of inpatient care for children with endocrine diseases; disability due to endocrine pathology, which has been carried out in recent years, is constantly growing, in particular diabetes, hypothyroidism and others; diseases and prevalence of malignant diseases of the endocrine glands in children. It is also possible to provide data from the register of children with active endocrine diseases, namely, diabetes mellitus, including its various forms, pathological short stature, the disorders of sex differentiation (DSD). The problematic issues of specialized care for children with diseases of the endocrine system are highlighted.It is estimated that according to the register of children with diabetes mellitus (DM) in 2020, 10,743 patients under the age of 18 were registered (14.26 per 10,000 children), including 10,598 children receiving insulin therapy (with DM Type 1, other types of diabetes requiring insulin treatment) (14.07), 51 — with DM type 2, 66 children with neonatal diabetes, of which 36 diagnoses are genetically confirmed, and MODY is genetically confirmed in 48 children. The prevalence of diabetes among children aged 0—18 years in 2020 increased compared to 2014 by 34.9 %.For patients with DSD conduct a detailed cytognetic examination in the leading genetic laboratories. Responding to the database of such children, to which 654 patients were includ, in particular with chromosomal DSD — 347 children (53.1 %, 303 patients with Turner syndrome); of 46, XY DSD — 102 patients (15.6 %); of 46, XX — 205 patients (31.3 %), as well as 185 children with DSD due to congenital adrenal hyperplasia.It is reported that in 2020, 1,630 children with short stature under the age of 18 who need treatment with growth hormone were registered in Ukraine, including 1,223 children with pituitary and pituitary-cerebral dwarfism, 255 children with Turner syndrome, 65 — with Russell—Silver syndrome, 43 — with Prader—Willi syndrome, 21 children with short stature, born small for their gestational age (SGA), as well as 22 children with dwarfism due to chronic renal failure. The number of such volumes increases by an average of 10 %. These children receive treatment with growth hormone drugs at the expense of the state budget.
Introduction. Recently, many studies have been devoted to the study of type 2 diabetes mellitus (DM2) worldwide. In most countries of the world, the increase in the prevalence of DM2 among children and adolescents is accompanied by an increase in childhood obesity. The presence of obesity or overweight in children can complicate the diagnosis of various types of DM. Detection and treatment of DM2 is extremely important for the society due to the wide range of severe diabetes complications.The aim of this work was to analyze the frequency of DM2 according to the Register of patients with DM, and to determine the state of glycemic control in children with DM2. Materials and methods. An analysis of glycemic control in children with DM2 who received various treatment regimens: with diet and lifestyle modifications, or with additional oral hypoglycemic agents (metformin monotherapy, or combination with insulin therapy). The glycemic control was assessed by measurement of glycated hemoglobin (HbA1c) level. Results. According to the data Register in Ukraine, the prevalence of DM among children has a tendency to rise — from 8.6 per 10 thousand children in 2005, to 13.14 — in 2019 year. The prevalence of DM2 in 2019 was 0.47 % of all cases of DM, and its prevalence contained 0.062 per 10 thousand children under 19 years of age with significant differences in the frequency of its diagnosis in different regions of Ukraine. We analyzed the state of glycemic control in children with DM2 aged from 9 up to 19 years old (Me 16.2 [15.5; 18.0]), with a disease duration 0.5—12 years (Me 4.5 [1.0] ; 7.5]). The age of diagnosis of DM2 was 2-17 years old (Me 11.7 [8.5; 15.0]), and 91.3 % of patients had obesity. Diet and lifestyle modifications were used in 34.8 % of patients, metformin monotherapy in 52.2 %, and metformin and insulin combination therapy in 13 % of patients. HbA1c values ranged from 5.0 to 11.4 % (Me 7.2 % [5,8; 8,0]). The proportion of children who had ideal or optimal glycemic control (HbA1c 7.0—7.5 %) was 52.2 %, suboptimal (HbA1c 7.6—9.0 %) — 39.1 %, high-risk glycemic control (HbA1c> 9.1 %) — 8.7 % of children. The most unsatisfactory HbA1c levels were registered in children who received metformin in combination with insulin (Me 10.6 % [10,15; 11,4]). Chronic complications of DM2 have not been reported.Conclusions. We found a low prevalence of DM2 among the pediatric population in Ukraine, more likely due to the low quality of its detection among children diagnosed with DM, as well as among children among high risk groups. Most children with DM 2 were obese. The majority of patients with DM2 (52.2 %) received metformin monotherapy, more than a third did not receive oral hypoglycemic agents. In most children with DM2 (52,2 %), the state of glycemic control corresponded to the optimal (< 7.5 %), but higher levels of HbA1c were found children who received metformin in combination with insulin.
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