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General characteristics of the examined children with
diabetes
Farangiz AMRIDINOVA
1
Tashkent Medical University
ARTICLE INFO
ABSTRACT
Article history:
Received April 2025
Received in revised form
15 May 2025
Accepted 25 May 2025
Available online
15 June 2025
Diabetes mellitus (DM) is one of the leading medical and social
problems of modern medicine. The incidence of insulin-dependent
diabetes mellitus is increasing worldwide. It is assumed that this is
mainly due to hereditary forms of diabetes mellitus (over 50% of
cases). Among children whose parents suffer from diabetes
mellitus, the incidence reaches 30% or more. WHO materials
indicate that over the past 15 years in economically developed
countries, the number of patients with diabetes mellitus has
doubled, while there is an increase in the incidence among
children under 5 years of age. Children with DM account for about
5% of all patients with diabetes. Despite significant progress
achieved in the treatment of type 1 diabetes mellitus, the life
expectancy of such patients is below the population average.
At the same time, mortality among young people has significantly
increased. Therefore, in our country, children from the moment of
diagnosis of diabetes mellitus receive the legal status of lifelong
disability as a measure of social assistance. Epidemiological
studies conducted in different countries indicate an increase in the
incidence of type 1 diabetes in children over the past decades.
For example, a significant increase in the incidence in all age
groups of children was noted in Finland (43 identified patients per
100,000 population per year). In Sweden, Norway, and Denmark,
2 times lower. In the UK, this figure is up to 7
–
8 per
100,000 population. The lowest incidence is in Japan and Israel,
where no more than 6 cases per 100,000 population are
registered annually. Diabetes is more common in people of African
and Mexican descent, and is widespread in the countries of the
Arab East and India. A significant increase in the incidence of
diabetes has also been noted: from 5.7 in 2019 to 14.6:
100,000 child population in 2022.
2181-
1415/©
2025 in Science LLC.
https://doi.org/10.47689/2181-1415-vol6-iss5/S-pp603-607
This is an open access article under the Attribution 4.0 International
(CC BY 4.0) license (https://creativecommons.org/licenses/by/4.0/deed.ru)
Keywords:
polyneuropathy,
diabetes,
distribution,
clinical picture.
1
Tashkent Medical University. E-mail: farikcha15gmail.com
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604
Qandli diabet bilan og‘rigan tekshirilgan bolalarning
umumiy xususiyatlari
ANNOTATSIYA
Kalit so‘zlar
:
polinevopatiya,
diabet,
tarqalish,
klinik ko
‘
rinish.
Qandli diabet (DM) zamonaviy tibbiyotning yetakchi tibbiy
va ijtimoiy muammolaridan biridir.
Insulinga bog‘liq diabet
kasalligi butun dunyo bo‘ylab ortib bormoqda. Bu, asosan,
qandli diabetning irsiy shakllari (50% dan ortig‘i) tufayli yuzaga
keladi, deb taxmin qilinadi. Ota-onasi qandli diabet bilan
og‘rigan bolalar orasida kasallanish 30% yoki undan ko‘proqqa
etadi. JSST materiallari shuni ko‘rsatadiki, so‘nggi 15 yil ichida
iqtisodiy rivojlangan mamlakatlarda qandli diabet bilan
kasallanganlar soni ikki
baravar ko‘paygan, 5 yoshgacha bo‘lgan
bolalar orasida kasallanish ko‘paygan. Qandli diabet bilan
og‘rigan bolalar diabetga chalingan barcha bemorlarning
taxminan 5% ni tashkil qiladi. 1-toifa diabetni davolashda
sezilarli yutuqlarga qaramay, bunday bemorl
arning umr ko‘rish
davomiyligi aholining o‘rtacha darajasidan past. Shu bilan birga,
yoshlar o‘rtasida o‘lim sezilarli darajada oshdi. Shu bois
mamlakatimizda bolalar qandli diabet tashxisi qo‘yilgan
paytdan boshlab ijtimoiy yordam chorasi sifatida umrbod
nogironlik huquqiy maqomini oladi. Turli mamlakatlarda
o‘tkazilgan epidemiologik tadqiqotlar so‘nggi o‘n yilliklarda
bolalarda
1-
toifa
diabet
kasalligining
ko‘payishini
ko‘rsatmoqda. Masalan, Finlyandiyada bolalarning barcha yosh
guruhlarida kasallanishnin
g sezilarli o‘sishi qayd etilgan
(har yili 100 000 aholiga 43 bemor aniqlangan). Shvetsiya,
Norvegiya, Daniyada
–
2 baravar kam. Buyuk Britaniyada bu
ko‘rsatkich hozirda 100
000 aholiga 7
–
8 tani tashkil etadi.
Eng kam kasallanish Yaponiya va Isroilda bo‘
lib, har yili
100
000 aholiga 6 tadan ko‘p bo‘lmagan kasallik qayd etiladi.
Qandli diabet ko‘proq afrikalik va meksikalik odamlarda
uchraydi va Arab Sharqi va Hindistonda keng tarqalgan. Qandli
diabet bilan kasallanishning sezilarli o‘sishi ham qayd etilga
n:
2019-yildagi 5,7 dan 14,6 gacha: 2022-yilda 100 000 bola.
Общая характеристика обследованных детей с
сахарным диабетом
АННОТАЦИЯ
Ключевые слова:
полинейропатия,
диабет,
распространение,
клиника.
Сахарный диабет (СД) –
одна из ведущих медико
-
социальных проблем современной медицины. Во всем мире
отмечается рост заболеваемости инсулинзависимым
сахарным диабетом. Предполагается, что происходит это, в
основном, за счет наследственных форм сахарного диабета
(свыше 50% случаев). Среди детей, родители которых
страдают сахарным диабетом, заболеваемость достигает
30% и более. В материалах ВОЗ имеются указания на то,
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что за последние 15 лет в экономически развитых странах
число больных сахарным диабетом увеличилось в 2 раза,
при этом отмечается рост заболеваемости среди детей
до 5 лет. Дети с СД составляют около 5% всех больных
диабетом.
Несмотря
на
значительный
прогресс,
достигнутый в терапии сахарного диабета 1
-
го типа,
продолжительность
жизни
таких
больных
ниже
среднепопуляционной. При этом значительно увеличена
смертность среди лиц молодого возраста. Поэтому в нашей
стране дети с момента установления диагноза сахарного
диабета в качестве меры социальной помощи получают
юридический
статус
пожизненной
инвалидности.
Эпидемиологические исследования, проведенные в разных
странах, свидетельствуют об увеличении заболеваемости
детей
СД
1-
го
типа
за
последние
десятилетия.
Так, например, значительное увеличение заболеваемости
во всех возрастных группах детей отмечено в Финляндии
(43 выявленных больных на 100
000 населения в год).
В Швеции, Норвегии, Дании –
в 2 раза ниже.
В Великобритании эта цифра составляет на сегодняшний
день до 7–8 на 100
000 населения. Наименьшая
заболеваемость в Японии и Израиле, где ежегодно
регистрируется не более 6 случаев на 100 000 населения.
Диабет чаще встречается у лиц африканского и
мексиканского происхождения, широко распространен в
странах Арабского Востока и Индии. Отмечен также
значительный рост заболеваемости СД: с 5,7 в 2019
г.
до 14,6: 100
000 детского населения в 2022 году.
Diabetic polyneuropathy is the most common complication of diabetes mellitus. In
2018, the World Conference on Diabetic Neuropathy was held in San Antonio, USA, where
this condition's definition was adopted. Diabetic neuropathy is a group of clinical and
subclinical syndromes, each marked by diffuse or focal damage to peripheral or
autonomic nerve fibers caused by diabetes mellitus. The most common form of
neuropathy in children is distal symmetric sensory-motor polyneuropathy. The main
signs of diabetic peripheral neuropathy in children include leg pain and paresthesia, as
well as impaired vibration, tactile, temperature, and pain sensitivity. In severe cases of
distal polyneuropathy, children may exhibit a loss of vibration sensitivity. Typically, the
distal parts of the lower extremities are affected symmetrically. Diabetic neuropathy can
lead to more serious complications, such as diabetic foot.
The aim of the research
is to investigate the clinical features, neurophysiological
picture, and dynamics of these indicators in children with diabetic polyneuropathy
against the background of basal-bolus insulin therapy and adjuvant treatment.
OBJECTIVES AND METHODS OF THE STUDY
To identify the timing of the debut and the nature of the manifestation of
neuropathic disorders in children with type 1 diabetes mellitus. To determine the
neurophysiological manifestations of diabetic polyneuropathy in children. Based on a
comparison of clinical and electroneuromyography indicators, to clarify the nature of
functional changes in children with diabetic polyneuropathy.
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RESULTS OF THE STUDY
Type 1 diabetes mellitus (T1DM) is an important medical and social problem of
modern pediatrics, which is due to the increase in its prevalence among children and
adolescents in recent years and the early appearance of disabling complications. One of
the most common, but least studied complications of diabetes mellitus in childhood is
diabetic peripheral polyneuropathy (DPN)
–
a distal symmetrical lesion of nerve fibers,
mainly in the lower extremities, characterized by the development of atrophy,
degeneration, and demyelination of axons. The incidence of DPN in children and
adolescents with type 1 diabetes, according to various authors, ranges from 5% to 90%,
while the predominantly low detection rate of this complication is associated with
difficulties in its diagnosis due to the prevalence of mild, including asymptomatic
(subclinical) forms in childhood and adolescence, and the lack of proper alertness
regarding the development of peripheral polyneuropathy in type 1 diabetes in pediatric
practice. Late diagnosis and untimely treatment lead, in turn, to the steady progression of
DPN, decreased quality of life, an increased risk of developing the "diabetic foot"
syndrome at a young age, amputations of the lower limbs, with the development of
persistent loss of working capacity and early disability of patients. This dictates the need
to develop methods for early diagnosis of DPN, especially at the preclinical stage of the
disease, assessment of severity, prognosis of the course, and effective methods of
therapy. In terms of solving this problem, a promising direction is further study of the
pathogenesis of DPN from the standpoint of determining the role of endothelium
–
dependent and neurotrophic factors in the development of this complication of type
1 diabetes, since, according to existing modern concepts, the formation of DPN is
considered from the point of view of both vascular and metabolic theories. At the same
time, it is extremely important to establish the nature of the relationship between
vasoactive, growth and neurotrophic factors at different stages of the development of
DPN in children and adolescents with type 1 diabetes, but the literature data on this issue
are few, contradictory and presented mainly in experimental studies and in adults. The
above opens up prospects for solving the problem of early diagnosis, assessment of
severity, prognosis of the course and optimization of treatment of this formidable
disabling complication of type 1 diabetes in children and adolescents. Data on the
frequency of DPN in diabetes mellitus both in adults and children are contradictory,
which is explained by the use of different methods for its diagnosis. Detection of DPPN at
early (subclinical) stages in children and adolescents is one of the complex and urgent
tasks in modern pediatric endocrinology and pediatrics. It is believed that diabetic
peripheral polyneuropathy develops after several years of diabetes mellitus, but some
patients with newly diagnosed diabetes have its clinical manifestations confirmed by
electromyographic research. The pathogenesis of DPPN development has not been fully
studied to date. The formation of DPPN is based on progressive loss of myelinated fibers
–
segmental demyelination and axonal degeneration, due to which the processes of
impulse conduction along the nerve fiber are disrupted. Hyperglycemia triggers a
cascade of metabolic and vascular disorders that cause the development of DPPN. In this
regard, the primary goal in the treatment of neuropathy should be the normalization of
glycemia levels. At the same time, it is known that DPPN can also develop in well-
compensated patients. This determines the need to study the various mechanisms of its
occurrence. In recent years, the attention of researchers has been drawn to the study of
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the dynamics of nitric oxide production as an important pathogenetic factor in the
development of late complications of diabetes, as well as a possible criterion for
assessing the treatment of diabetic peripheral polyneuropathy. Due to the lack of precise
understanding of the mechanisms of damage to peripheral nerves, treatment methods
that would be the "gold standard" of effective therapy for DPPN have not been developed.
This determines the need to search for new methods of therapy for DPPN aimed at
slowing the progression of nerve damage. In complex treatment, a significant part is
occupied by physical methods of therapy, in particular, the use of a magnetic field. It has
been proven that magnetic therapy in traumatic damage to peripheral nerves leads to
fairly rapid, and often complete, nerve regeneration. Of all magnetic fields, the running
pulse magnetic field (RPMF) has the largest set of biological effects (vasodilatory, anti-
inflammatory and regenerative), due to the presence of the maximum set of its biotropic
parameters.
CONCLUSIONS
For the first time, clinical and neurophysiological characteristics were given in
children suffering from type 1 diabetes mellitus, and the severity of difficult to objectify
sensory disorders was determined. Based on clinical and neurophysiological
comparisons and statistical dispersion analysis, a scheme for assessing the severity of
diabetic polyneuropathy was presented.
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