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Dissertação
Avaliação do crescimento linear em crianças com o diagnóstico de Diabetes Mellitus Tipo 1
The Type 1 Diabetes Mellitus (T1DM) is characterized by the destruction of the ß-cells resulting in loss of endogenous insulin production. It is one of the most common presentations of youth-onset diabetes. The treatment needs multi-disciplinary approach and is based on intensive insulin therapy....
Autor principal: | BARBOSA, Bruna Lopes |
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Grau: | Dissertação |
Idioma: | por |
Publicado em: |
Universidade Federal do Pará
2025
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Assuntos: | |
Acesso em linha: |
https://repositorio.ufpa.br/jspui/handle/2011/17270 |
Resumo: |
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The Type 1 Diabetes Mellitus (T1DM) is characterized by the destruction of the ß-cells
resulting in loss of endogenous insulin production. It is one of the most common presentations
of youth-onset diabetes. The treatment needs multi-disciplinary approach and is based on
intensive insulin therapy. The chronic hyperglycemia and severe insulin deficiency are known
to be associated with impaired linear growth. The dysregulation of the GH-IGF-1 axis in T1DM
is characterized by decreases in circulating IGF-1, GHR and GHBP, along with increases in
GH and IGFBP-1. This study evaluated the influence of glycemic control in the linear growth
of T1DM patients treated at Universitary Hospital João de Barros Barreto and compared the
growth of these patients with the WHO`s reference. For that, a retrospective cohort study was
made using data from medical records at the period between 5 and 19years old from 78 patients
(40 females/ 38 males) following the criteria of age at the diagnosis £ 15 years old (females)
and £ 17 years old (males). They were at diagnosis 8,6 years old, the duration of the disease
was de15,4 years, glycated hemoglobin (HbA1C) 10,5 %. Among them, 58 patients (28
females/ 28 males) were achieved the final height (FH). The female’s FH was 156,2cm (Z score
-1,11SDS) and the male’s FH was 166cm (Z score -1,45SDS). Only 19% were above the OMS`s
media. But 26% had short stature. 9% were at Z≤ -3SDS. HbA1C ≥ 9,5% was related with
worse FH. Each 1% of elevation in HbA1C was associated with a reduction of 2,23cm on FH,
and 26% of FH variability were influenced by HbA1C level. The ones with HbA1C ³ 9% had
significant stature loss compared to TH. In conclusion, the T1DM patients evaluated were
shorter than the media of WHO`s charts, however the majority did not have short stature.
HbA1C levels were negatively associated with stature loss compared to TH and final heigh.
There was no correlation between FH and weight, insulin total dose, gender and diabetes
duration. |