Аннотация:
BACKGROUND: In coexistence of diabetes mellitus type 1 (DM1) with severe autoimmune and inflammatory diseases some patients need simultaneous administration of insulin and glucocorticoids (GC). GC therapy in patients with DM1 can worsen glycemic control. AIM: To determine characteristics of insulin therapy of DM1 in children and adolescents receiving GC. DESCRIPTION OF CLINICAL CASES: We observed 5 patients with DM1 receiving GC for juvenile idiopathic arthritis (JIA), juvenile systemic sclerosis (JSS), juvenile dermatomyositis (JDM), ulcerative colitis (UC), and reactive arthritis (RA). Intra-articular administration of GC did not significantly influence glycemic control. In case of GC pulse therapy hyperglycemia and increased insulin requirements were recognized in 3–6 hours after GC receipt, persisted from few hours up to 3 days after each administration. While therapy with oral GC in high doses the worst glycemic control was registered in daylight hours. To overcome insulin resista
Витебская А. В. Алиса Витальевна 1975-
Попович А. В.
Афонина Е. Ю. Елена Юрьевна 1966-
Костина Ю. О. Юлия Олеговна 1985-
Алексанян К. В.
Грамматопуло М. И. Мария Ивановна 1957-
Яблокова Е. А. Екатерина Александровна 1977-
Шпитонкова О. В. Ольга Викторовна 1963-
Vitebskaya A. V. Alisa Vitalyevna 1975-
Popovich A. V.
Afonina E. Yu. Elena Yuryevna 1966-
Kostina Yu. O. Yuliya Olegovna 1985-
Aleksanyan K. V.
Grammatopulo M. I. Mariya Ivanovna 1957-
Yablokova E. A. Ekaterina Aleksandrovna 1977-
Shpitonkova O. V. Ol`ga Viktorovna 1963-
Characteristics of insulin therapy of diabetes mellitus type 1 in children and adolescents receiving glucocorticoids [Особенности инсулинотерапии при сахарном диабете 1 типа у детей и подростков, получающих глюкокортикоиды]
Characteristics of insulin therapy of diabetes mellitus type 1 in children and adolescents receiving glucocorticoids [Особенности инсулинотерапии...
Текст визуальный непосредственный
Сахарный диабет
Федеральное государственное бюджетное учреждение Национальный медицинский исследовательский центр эндокринологии Министерства здравоохранения Российск
Т. 22, Вып. 3 С. 263-273
2019
Статья
Children Diabetes mellitus Glucocorticoids
glucocorticoid glycosylated hemoglobin human insulin insulin insulin derivative long acting insulin short acting insulin adolescent Article child clinical article corticosteroid therapy diabetic patient drug megadose drug pulse therapy glycemic control hemoglobin blood level human hyperglycemia insulin dependent diabetes mellitus insulin resistance insulin treatment juvenile dermatomyositis juvenile rheumatoid arthritis long term care maintenance drug dose medication compliance patient compliance prescription reactive arthritis sunlight systemic sclerosis ulcerative colitis
BACKGROUND: In coexistence of diabetes mellitus type 1 (DM1) with severe autoimmune and inflammatory diseases some patients need simultaneous administration of insulin and glucocorticoids (GC). GC therapy in patients with DM1 can worsen glycemic control. AIM: To determine characteristics of insulin therapy of DM1 in children and adolescents receiving GC. DESCRIPTION OF CLINICAL CASES: We observed 5 patients with DM1 receiving GC for juvenile idiopathic arthritis (JIA), juvenile systemic sclerosis (JSS), juvenile dermatomyositis (JDM), ulcerative colitis (UC), and reactive arthritis (RA). Intra-articular administration of GC did not significantly influence glycemic control. In case of GC pulse therapy hyperglycemia and increased insulin requirements were recognized in 3–6 hours after GC receipt, persisted from few hours up to 3 days after each administration. While therapy with oral GC in high doses the worst glycemic control was registered in daylight hours. To overcome insulin resista