MODERN VIEW ON DIAGNOSTICS AND PRE VENTION OF LIPODYSTROPHIES IN PATIENTS WITH DIABETES MELLITUS
Keywords:diabetes mellitus, glycemic variability, lipodystrophy, ultrasound
The article discusses the modern possibilities of improving the diagnosis, prevention and timely treatment
of lipodystrophy in patients with type 1 diabetes and their effect on the compensation of type 1 diabetes in
children. A review of international studies on lipodystrophy (LD) and their own results are presented. In 150 patients with type 1 diabetes at the age of 6–17 years, equally distributed by compensation level, diabetes and
gender experience, LD was determined visually, by palpation, as well as by ultrasound of subcutaneous fat
(TFA) 265 insulin injection sites. Blood circulation was studied in the affected areas of the pancreas. Glycemic
control indices were calculated taking into account the coefficient of variability (CV) in patients with and without LD. According to the results of a clinical examination, LDs were found in 38% of patients, according to
ultrasound tests of pancreatic cancer 265 insulin injection sites — in 72% of patients. Most often (61%), LDs
were found in the paraumbilical region, in shape: diffuse — 56% focal — 24%, mixed — 15%, in the thigh region — muscular (3%) and atrophic (2%). LD prevailed (in 84%) among patients with high risk glycemic control
(average level of glycosylated hemoglobin — НВА1с = 10.42%). Among children with optimal glycemic control
(HBA1c = 7.8%), 85% had no lipodystrophy (p < 0.001). Accordingly, high variability (CV > 36%) was determined in 62% of patients with LD, and only in 28% of patients without LD (p < 0.05). Thus, the relationship
between the presence of LD and glycemic parameters in children and adolescents with type 1 diabetes mellitus,
which affect the variability of glycemia and the formation of complications of diabetes, is determined.
The use of ultrasound once every 6 months is necessary to diagnose the state of subcutaneous fat at the
injection sites of insulin in children with type 1 diabetes. Prevention of LD is possible by using short needles
(4 mm) and following the injection technique.
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