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Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12710/17015
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dc.contributor.authorCosmescu, Adriana
dc.contributor.authorOltean, Carmen
dc.contributor.authorAnton-Păduraru, Dana-Teodora
dc.contributor.authorComan, Adorata
dc.date.accessioned2021-05-24T10:29:56Z
dc.date.available2021-05-24T10:29:56Z
dc.date.issued2018
dc.identifier.citationCOSMESCU, Adriana, OLTEAN, Carmen, ANTON-PĂDURARU, Dana, COMAN, Adorata. Algoritm de diagnostic al hiperglicemiei la copil = Diagnostic algorithm of hyperglycemia in children. In: Buletin de perinatologie. 2018, nr. 4(80), pp. 81-82. ISSN 1810-5289.en_US
dc.identifier.issn1810-5289
dc.identifier.urihttps://mama-copilul.md/images/buletin-perinatologic/BP_2018/4_2018.pdf
dc.identifier.urihttp://repository.usmf.md/handle/20.500.12710/17015
dc.descriptionUniversitatea de Medicină şi Farmacie ”Grigore T.Popa”,Iaşi, România, Spitalul clinic de urgentă pentru copii “Sf.Maria”, Iaşi, Româniaen_US
dc.description.abstractDefi nim hiperglicemia prin creşterea glicemiei a jeun peste 110 mg/dl sau printr-o glicemie oricand in cursul zilei peste 140 mg/dl. În practica pediatrică, aceste valori pot fi cauzate de anumite medicamente, de stres sau pun problema apariţiei diabetului zaharat. Dintre medicamentele care pot determina hiperglicemie menţionăm steroizii, tiazidele, hormonul de creştere şi unele antipsihotice. Acestea din urmă au fost asociate cu o incidenţă crescută a diabetului de tip 2 si cu înrăutăţirea controlului metabolic în diabetul de tip 1. Hiperglicemia de stres poate avea cauze minore, spre exemplu o infecţie de tract respirator superior, sau cauze severe, chirurgicale. Hiperglicemia din infecţiile minore poate anunţa apariţia unui diabet de tip 1 sau diabet MODY şi trebuie investigată ulterior. Dacă valorile glicemiei sunt peste 126 mg/dl a jeun şi peste 200 mg/dl în cursul zilei, se stabileşte diagnosticul de diabet zaharat. În peste 90% din cazuri, în copilărie şi adolescenţă se diagnostichează diabetul de tip 1, pe baza simptomelor tipice si prin confi rmarea patogeniei autoimune, respectiv a markerilor de autoimunitate. Există şi posibilitatea unui diabet secundar asociat anumitor afectiuni, cum ar fi fi broza chistică, talasemia, feocromocitomul sau afecţiuni genetice. Când valorile glicemiei a jeun sunt între 100-125 mg/dl, pentru a diferenţia diabetul zaharat de tip 2 de un diabet monogenic sau de un prediabet, se recomandă efectuarea testului oral de toleranţă la glucoză asociat cu determinarea hemoglobinei glicozilate A1c, a anticorpilor anticelule insulare ( ICA ), a anticorpilor antiinsulinici şi a peptidului C. În prezent, se remarcă o crestere a incidenţei diabetului zaharat de tip 2 la populatia pediatrică, şi anume la pacientii cu obezitate şi istoric familial pozitiv de obezitate şi/sau diabet de tip 2, cu valori normale sau crescute ale peptidului C şi fără autoanticorpi prezenţi. Diabetul de tip MODY apare la 2-3,5 % din cazurile de diabet zaharat, copiii având un fenotip extrem de variabil, nu prezinta autoanticorpi, iar transmiterea autosomal dominanta este demonstrata de istoricul familial de diabet la 2-3 generaţii. În concluzie, hiperglicemia la copil pune probleme de diagostic diferenţial între debutul diabetului zaharat, un diabet secundar, o hiperglicemie indusa medicamentos sau o hiperglicemie de stres.en_US
dc.description.abstractHyperglycemia is defined as an increase of the fasting blood glucose level above 110 mg/dl or by random blood glucose level above 140 mg/dl. In pediatric practice, these values may be caused by certain medications, by stress or they may be an indication of diabetes mellitus. Here are some of the medications that may cause hyperglycemia: steroids, thiazides, growth hormone, and some antipsychotics. The latter was associated with an increased incidence of type 2 diabetes and with poor metabolic control in type 1 diabetes. Hyperglycemia caused by stress may have minor causes, for instance, an upper respiratory tract infection, or severe surgical causes. Hyperglycemia caused by minor infections may be the precursor of type 1 diabetes or of MODY diabetes and it should be further and more thoroughly analyzed. When the fasting blood glucose levels exceed 126 mg/dl and when the blood glucose levels are over 200 mg/dl at any time during the day, the diabetes mellitus diagnosis is set. Type 1 diabetes is diagnosed during childhood and adolescence in over 90% of the cases, based on specific symptoms and when confirmed by autoimmune pathogenicity, i.e. autoimmunity markers. There is also the possibility of secondary diabetes associated with certain conditions such as cystic fibrosis, thalassemia, pheochromocytoma, or genetic disorders. When fasting blood glucose levels are between 100-125 mg/dl, in order to distinguish type 2 diabetes from monogenic diabetes or from prediabetes, an oral glucose tolerance test is recommended together with the determination of glycosylated hemoglobin A1c, anti-islet cells (ICA), anti-insulin antibodies, and peptide C. Nowadays, there is an increase in the incidence of type 2 diabetes in the pediatric population, namely in patients with obesity and family history of obesity and/or type 2 diabetes, with normal or elevated C-peptide levels and no autoantibodies present. MODY diabetes occurs in 2-3.5% of the cases of diabetes, as children have a very variable phenotype, do not show autoantibodies, and dominant autosomal transmission is demonstrated by family history of diabetes in 2-3 generations. To conclude, hyperglycemia in children poses a differential diagnosis problem, as it is difficult to distinguish between the onset of diabetes mellitus, secondary diabetes, medication-induced hyperglycemia, or stress-caused hyperglycemia.en_US
dc.publisherInstituţia Medico-Sanitară Publică Institutul Mamei și Copiluluien_US
dc.relation.ispartofBuletin de perinatologieen_US
dc.subjecthyperglycemiaen_US
dc.subjectchilden_US
dc.subjectdiabetes mellitusen_US
dc.titleAlgoritm de diagnostic al hiperglicemiei la copilen_US
dc.title.alternativeDiagnostic algorithm of hyperglycemia in childrenen_US
dc.typeOtheren_US
Appears in Collections:Buletin de Perinatologie Nr. 4(80) 2018

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