Biliaieva K. Type 1 diabetes mellitus in adolescents: impact of vitamin D status

The study is devoted to the solution of the urgent problem of modern endocrinology - improving the compensation of type 1 diabetes mellitus based on the study of the mechanisms of the influence of the status of vitamin D on the glycemic control and the structural and functional state of the bone system in adolescents by establishing the clinical features of the course of the disease in combination with deficiency and insufficiency of the vitamin D, indicators of compensation of carbohydrate metabolism, as well as evaluation of the effectiveness of normalization of vitamin D levels among adolescents with type 1 diabetes mellitus. The thesis focuses on the role of late puberty in the course of type 1 diabetes as one of the critical periods in the development of the child's body, during which the highest prevalence of vitamin D deficiency was established , which is higher than the frequency of this vitamin deficiency in the group of adolescents of early puberty (p<0,05). For the first time, a gender difference in the level of vitamin D among adolescent patients with type 1 diabetes was revealed - the level of vitamin D in boys is 1,3 times lower than in girls with diabetes mellitus type 1 (16,60 ng/ml vs. 21,07 ng/ml respectively, p<0,05). For the first time the prediction of the risk of developing diabetic complications was analyzed depending on the degree of the vitamin D levels. The presence of osteopenia was established in 89,47 % of the examined patients according to the Z-score parameter among adolescents with type 1 diabetes mellitus. The results of the study revealed positive effect of cholecalciferol intake in adolescents with type 1 diabetes. The normalization of vitamin D level affected the state of compensation of the disease, which was confirmed by a statistically significant decrease in the level of glycosylated hemoglobin compared to the initial values of this indicator, and, as a result, the amount of patients with type 1 diabetes mellitus with decompensation of the disease decreased by 2,7 times (p<0,05).