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001-es BibID:BIBFORM024317
Első szerző:Barkai László (gyermekgyógyász)
Cím:Prospective assessment of severe hypoglycaemia in diabetic children and adolescents with impaired and normal awareness of hypoglycaemia / L. Barkai, I. Vámosi, K. Lukács
Dátum:1998
Megjegyzések:To establish whether impaired hypoglycaemic awareness is associated with increased rate of severe hypoglycaemia and to assess clinical predictors of severe episodes without warning symptoms a prospective study of 130 insulin- dependent diabetic children and adolescents was undertaken for 1 year. Using a structured questionnaire, 48 patients reported impaired awareness and 82 reported normal awareness of hypoglycaemia at baseline of the study. The two groups did not differ regarding clinical and metabolic characteristics. Episodes of severe hypoglycaemia were recorded for 1 year. The rate of severe hypoglycaemia was higher in the group with impaired awareness than in the group with normal awareness (p < 0.0001). Of the severe hypoglycaemic episodes, 34.0 % developed without warning symptoms. Patients with impaired awareness experienced more severe episodes without warning symptoms than those with normal awareness (p = 0.0054). Severe hypoglycaemia occurred more frequently in patients with impaired awareness aged 6 years and less (p = 0.0041) than in older counterparts. Impaired awareness reported at baseline [adjusted odds ratio (OR): 5.8; p = 0.0021], age 6 years or less (3.4; p = 0.0121), previous severe episode (4.8; p = 0.0043) and more than 5 % of home blood glucose readings 3.3 mmol/l or less in the preceding month (4.2; p = 0.0211) proved to be independently predictive of severe hypoglycaemic events without warning symptoms. In conclusion, impaired hypoglycaemic awareness is associated with an increased rate of severe hypoglycaemia in diabetic children and adolescents. One third of severe episodes developed without warning symptoms. Impaired awareness, young age and recent biochemical or severe hypoglycaemias are independent risk factors for such episodes. Avoidance of hypoglycaemia should be a priority in pre-school children with diabetes.
PubMed ID: 9726591 UR: http://www.scopus.com/inward/record.url?eid=2-s2.0-0031843066&partnerID=40&md5=6239e776d4bfd076f7fb0750140abf5f
http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-0031843066
Tárgyszavak:Orvostudományok Klinikai orvostudományok magyar nyelvű folyóiratközlemény hazai lapban
Questionnaires
Prospective Studies
Multivariate Analysis
Male
Infant
hypoglycemia
Humans
Hemoglobin A, Glycosylated
Female
Diabetes Mellitus, Type 1
Child, Preschool
Child
awareness
Adolescent
risk management
risk factor
priority journal
patient guidance
patient education
major clinical study
human
controlled study
conference paper
clinical trial
blood glucose monitoring
Type I diabetes
Hypoglycaemic awareness
Hypoglycaemia
CHILDREN
Megjelenés:Diabetologia : Clinical and experimental diabetes and metabolism. - 41 : 8 (1998), p. 898-903. -
További szerzők:Vámosi Ildikó Lukács Katalin
Internet cím:DOI
Intézményi repozitóriumban (DEA) tárolt változat
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2.

001-es BibID:BIBFORM024315
Első szerző:Barkai László (gyermekgyógyász)
Cím:Enhanced progression of urinary albumin excretion in IDDM during puberty / László Barkai, Ildikó Vámosi, Katalin Lukács
Dátum:1998
Megjegyzések:OBJECTIVE - To determine whether the progression of urinary albumin excretion rate (AER) is higher during puberty than before or after this period. RESEARCH DESIGN AND METHODS - A prospective study was conducted in which normoalbuminuric prepubertal (n = 20), pubertal (n = 28), and postpubertal (n = 26) IDDM groups matched for diabetes duration and long- term metabolic control were followed for 3 years. At 6-month intervals, 24-h urine collection was used to determine AER. RESULTS - AER increased significantly over a period of 3 years in the pubertal (P = 0.001) and postpubertal (P = 0.003) subjects but not in prepubertal subjects. The annual progression of AER was significantly higher in the pubertal group than in the prepubertal (P = 0.001) or postpubertal (P = 0.001) groups. Six pubertal, two postpubertal, and none of the prepubertal subjects developed microalbuminuria (AER ?20 ?g/min on two consecutive occasions) over a 3-year period (P = 0.047). Multiple logistic regression analysis showed that the risk of development of microalbuminuria was increased in pubertal subjects compared with the prepubertal and postpubertal subjects (adjusted relative risk [95% CI]: 4.3 [1.5-9.3], P = 0.012. and 2.1 [1.1-5.0]. P = 0.023, respectively). CONCLUSIONS - Puberty represents an independent risk of the development of microalbuminuria in diabetes. This finding suggests that the endocrine changes of puberty lead to an accelerated process of early kidney damage in diabetes. In pediatric diabetes care, screening for microalbuminuria is needed soon after the onset of puberty.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Triglycerides
Risk Factors
Regression Analysis
puberty
Prospective Studies
Male
Humans
Follow-Up Studies
Female
DISEASE PROGRESSION
Diabetes Mellitus, Type 1
Cholesterol
Child
Body Constitution
Blood Pressure
Albuminuria
Adolescent
urinary excretion
Treatment Outcome
subcutaneous drug administration
major clinical study
insulin treatment
insulin dependent diabetes mellitus
human
diabetic nephropathy
diabetes mellitus
controlled study
ARTICLE
somatomedin C
INSULIN
albumin
Megjelenés:Diabetes Care. - 21 : 6 (1998), p. 1019-1023. -
További szerzők:Vámosi Ildikó Lukács Katalin
Internet cím:DOI
Intézményi repozitóriumban (DEA) tárolt változat
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