The problem of insulin resistance in children with type 1 diabetes. Рart 1
Journal Title: Український журнал дитячої ендокринології - Year 2019, Vol 0, Issue 1
Abstract
Currently the incidence and prevalence of type 1 diabetes in children increase. The cause of this phenomenon is not only genetic factors. The theory of accelerators is considered to be one of the possible explanations. Accelerators are factors that shift the manifestation of type 1 diabetes to an earlier age. There are two accelerators of autoimmune destruction of βcells: insulin resistance associated with overweight and genetic predisposition. The prevalence of overweight and obesity in children with newly diagnosed diabetes mellitus increased threefold between 1979—1989 and 1990—1998. It is suggested that currently diabetes develops in children with moderate genetic predisposition more often due to increasing prevalence of overweight in the population. According to a number of studies, the prevalence of overweight and obesity in children with type 1 diabetes is higher than in general population. High doses of insulin are found to be associated with overweight and increased risk of longterm complications of diabetes. Risk factors of reduced insulin sensitivity include long diabetes experience, puberty, relatives with obesity or type 2 diabetes, sedentary lifestyle, diet with protein and fat excess. Currently, there is much data regarding the role of insulin therapy in the pathogenesis of insulin resistance in type 1 diabetes: the mismatch of treatment to the physiological profile of hormone secretion in the body and iatrogenic «hyperinsulinization». Modification of lifestyle and nutrition, as well as the development of new technologies for the treatment of diabetes gives allow for expectation of insulin sensitivity improvement in patients with type 1 diabetes.
Authors and Affiliations
A. V. Solntsеva, N. V. Volkоva
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