ESPE Abstracts

Background: Due to the Ukrainian Pediatric Diabetes Register (UPDR) the number of children with DM1 0-17 y.o. in 2019 was 9860 (1 in 769), with Dm² 36 (1 in 210,547) with neonatal DM (NDM) 66 (1 in 115,000), with MODY 40 cases (1 in 114,844). The diabetes prevalence rates increased from 9.3 (per 1000) in 2007 up to 12,57 (per 1000) in 2018. CSII is well established in pediatric patients with DM1. Most studies focus on such parameters as HbA1c levels, hypoglycemia and quality of life, whereas no investigation of chronic complications has been widely described.

Materials and methods: The UPDR was created in 2004. It contains all information about children with DM1 aged 0-17 including HbA1c levels, the frequency of acute complications (diabetes ketoacidosis and severe hypoglycemia), chronic complications (cataract, retinopathy, nephropathy, peripheral neuropathy, steatohepatosis, cheiroarthropathy, angiopathy of legs etc). We studied the frequency of acute and chronic complications among 292 children aged 0-17 y.o. who were treated with CSII (n = 22) vs MDII (n = 270) and in different age groups (0-14 and 15-17 y.o) in the city of Dnipro.

Results: The incidence of diabetes in the city of Dnipro increased from 0.69 (per 10,000) in 2008 up to 1.07 (per 10,000) in 2018. At the same time, the pediatric population of Ukraine decreased from 10.3 million in 2002 to 7.6 million in 2018. The total number of patients with DM1 in Dnipro is 292. Among them, there are 190 children aged 0-14 years old (17 of whom receive CSII), and 102 adolescents (5 of whom receive CSII). The results of study showed the absence of a significant difference in the frequency of diabetes complications and HbA1c levels between CSII and MDII groups (P > 0.05), despite the fact that the duration of DM1 and age were similar. However, a significant increase (P < 0.05) of the frequency of complications (e.g. angiopathy of legs, peripheral neuropathy, cheiroarthropathy and HbAlc levels) was found in the 15-17 y.o. group (vs 0-14 y.o.) with the increase of the duration of DM1 (P < 0.05).

Conclusions: The study did not reveal any difference in the frequency of acute and chronic complications and HbA1c levels among patients with DM1 treated with CSII and MDII. The frequency of chronic complications and HbA1c level increases with age and duration of DM1 (P < 0.01). Further treatment modalities should be studied in a pediatric cohort with DM1, especially in adolescents (15-17 y.o).