Thesis paper is on the improving of early diagnosis methods, predicting of
diabetic myopathy development in children suffering from type 1 diabetes mellitus
(T1DM), and objectives of approaches on prevention its occurrence and progression by
studying the risk factors for its occurrence, the morphofunctional state of skeletal
muscles and serum myokine levels.
The paper presents examination data of 178 children of the age group 11-17
years (average age 14.09 ± 0.31 years), including 137 children suffering from type 1
diabetes mellitus (T1DM), who were divided into groups depending on the duration of
the disease. Group 1 consisted of 35 children who have been suffering from type 1
diabetes mellitus for up to 1 year, group 2 consisted of 49 patients, who have been
suffering from type 1 diabetes mellitus for the period from 1 to 5 years, group 3
included 53 children who have been suffering from type 1 diabetes mellitus for 5 and
more years. The control group consisted of 41 relatively healthy children who have no
endocrine pathology. All groups were represented by age and gender.
According to the results of the conducted study, it was discovered that children
suffering from T1DM, after increased duration of the disease and poor glycemic
control showed a deterioration of the functional state of the muscular system, which
manifested itself in a decrease in muscle strength, both static and dynamic one, which
was also accompanied by a decrease in the skeletal muscle index and an increase in the
percentage of fat mass, which indicated the development of diabetic myopathy, the
prevalence of which was 27 %. The most significant changes in the muscular system 8
were observed among girls, among whom diabetic myopathy occurred 2.3 times more
often than among boys (40.4 % vs. 17.5 %, respectively, p<0.05), while dynapenia was
recorded 1.3 times more often among boys (boys – 55.0 %, girls – 42.1 %). The
prevalence of occurrence of diabetic myopathy was growing due to the increase of
duration of the disease (r = +0.42) and poor glycemic control (r = +0.34).
The prevalence of development of
diabetic myopathy in children suffering from type 1 diabetes mellitus was established
for the first time. For the first time, the data was received on ultrasound of skeletal
muscle in children suffering from T1DM, depending on the gender, duration of the
disease and the state of glycemic control. The data on the functional state of skeletal
muscles in children suffering from T1DM, depending on the gender, duration of the
disease and the state of glycemic control was clarified. The data on the content of
markers of the oxidative stress (nitrotyrosine, homocysteine) and myokines levels
(myostatin, irisin, interleukin-6, and interleukin-13) in patients who have diabetic
myopathy was updated, and data on their levels depending on the duration of the
disease and the state of glycemic control was clarified. The pathogenetic factors were
identified which determine the development of diabetic myopathy in children suffering
from T1DM the best, and the predictors of the development of this complication were
clarified. Based on the obtained data, a prognostic model for the progression of
diabetic myopathy in children suffering from T1DM was developed. Approaches to the
prevention, early diagnosis and treatment of diabetic myopathy in children suffering
from type 1 diabetes mellitus were scientifically substantiated.11
A new method of diagnosing the diabetic myopathy in children suffering from type 1 diabetes mellitus
was proposed, which allows detecting its preclinical manifestations, evaluating the
effectiveness of prescribed therapy, and is based on sonomyography and additional
determination of irisin content (Patent of Ukraine for Utility Model No. 138547 dated
November 25, 2019). A prognostic model of diabetic myopathy occurrence in children
suffering from T1DM was proposed in order to determine further tactics of patient
care. A diagnostic algorithm of the doctor’s actions aimed at determining the risk
group and early diagnosis of diabetic myopathy in children who have T1DM was
developed. The need for inclusion of the children suffering from T1DM, alpha-lipoic
acid and static-dynamic physical activity to the complex therapy to prevent the
development and progression of diabetic myopathy was proved
