The aim of the study is to determine the diagnostic utility of several islet autoantibodies and their combinations in order to identify individuals susceptible to type 1 diabetes mellitus (T1DM) among healthy siblings in the pediatric population within the scope of the development of a screening program.MATERIALS AND METHODS:A total of 424 children were evaluated, 260 children with new-onset T1DM and 164 healthy children with brothers and/or sisters with T1DM.Blood tests for a complex of autoantibodies to insulin (IAA), tyrosine phosphatase (IA-2A), zinc transporter 8 (ZnT8A), pancreatic β-cells (ICA), and glutamate decarboxylase (GADA) were conducted in all the subjects with the enzyme immunoassay method.RESULTS:It was found that the diagnostic utility of individual autoantibodies is not equal and varies with age. The optimal age groups for the immunological control of the risks of developing type 1 diabetes in healthy siblings were determined. The highest risks were noted with the combination of GADA, ZnT8A, and IA-2A.CONCLUSION:Islet autoantibodies may serve as prognostic markers of the risk of developing type 1 diabetes in healthy siblings.

Background: Children with type 1 diabetes (T1D) are at high risk for severe influenza. Objective. Our aim was to assess immunogenicity and safety of a trivalent subunit immunoadjuvant influenza vaccine in children with T1D. Methods. The prospective study carried out from September to November 2014 included children with T1D at the age from 3 to 17 years vaccinated against influenza by a trivalent subunit immunoadjuvant influenza vaccine and unvaccinated due to parental refusal. Anti-influenza virus antibodies were determined by passive hemagglutination reaction. Vaccine safety was assessed by a number of adverse events occurred within 6 days after its administration. Observation was carried out during 1 year after vaccination (to October-November 2015 inclusive). Results. Of 780 children with T1D followed-up by endocrinologists in Nizhny Novgorod region, the study included 94 children — 44 vaccinated and 50 unvaccinated matched by sex and age. As for influenza A/H1N1/California/07/09 virus strain, the seroprotection rate (antibody titre > 1:40) was 84%, seroconversion rate (4-fold increase in antibody titre) was 66%, seroconversion factor (average increase of the antibody titre and 95% confidence interval) was 20.6 (10.4–30.9), as for influenza A/H3N2/Texas/50/12 virus, it was 98%, 41%, and 9.9 (3.2–16.6), as for influenza B/Massachusetts/2/12 virus, it was 77%, 49%, and 7.7 (4.0–11.4), respectively. After 1 year, the conditionally protective antibody titres (> 1:40) to influenza A/H1N1/California/07/09 virus were in 32/43 (74%), to influenza A/H3N2/Texas/50/12 virus — in 38/43 (88%), to influenza B/Massachusetts/2/12 virus — in 25/43 (58%) vaccinated children, in unvaccinated ones — 23/49 (47%) 37/49 (76%), and 6/49 (12%), respectively. Mild local adverse events were observed in 5/44 (11%), general — in 1/44 (2%), intercurrent diseases — in 8/44 (18%) vaccinated children. Conclusion. Immunogenicity and safety of a trivalent subunit immunoadjuvant influenza vaccine in children with T1D have been confirmed.

AIM:To evaluate the efficiency of using the vitamin and mineral complex (VMC) ALFAVIT Diabetes in the combination therapy of diabetic polyneuropathy (DPNP) in adolescents.SUBJECTS AND METHODS:A study group comprised 30 children with diabetic peripheral polyneuropathy, whose combination therapy included ALFAVIT Diabetes as one tablet t.i.d. for 2 months. A comparison group consisted of 20 adolescents with DPNP who did not take the complex. Before and 2 months after the study, the children's state was assessed from the data of a physical examination with mandatory blood pressure and pulse measurements and a neurological study, from carbohydrate (basal glycemia, glycemic variability, glycated hemoglobin) and lipid (total cholesterol and its fractions) metabolic parameters, and from the findings of electromyography (EMG).RESULTS:Incorporation of the VMC ALFAVIT Diabetes into the combination therapy contributed to the ameliorated clinical manifestations of DPNP. There were positive electrophysiological changes, as evidenced by EMG. The VMC ALFAVIT Diabetes showed good tolerability and caused no adverse reactions.CONCLUSION:The performed trials have indicated that it is expedient to use the VMC ALFAVIT Diabetes in adolescents with type 1 diabetes mellitus and DPNP.

The diabetes of 1 type at children and teenagers is a challenge. The beginning of illness at early age and threat of development of sharp and chronic complications already at young age cause search of the optimal methods of treatment of this heavy disease. In clause results of use of system of long monitoring гликемии (CGMS) and continuous hypodermic introduction of insulin (insulin pumps) in practical activities of children's doctorsendokrinology are presented. As a result of research opportunities помповой are shown to therapy and monitorings of a level гликемии in more safe and effective achievement of indemnification of a diabetes at children and teenagers.

The increase of morbidity with diabetes mellitus (DM) in children and adolescents during last years, and absence of adequate control of disease reveal the need of complex study of quality of life in these patients. The article presents the results of evaluation of quality of life rates, obtained with Russian versions of questionnaires PedsQL 4.0 Generic Core Scale and Diabetic Module in children and adolescents with diabetes type I, treated with different combinations of insulin drugs. The results showed that quality of life differs between group of healthy adolescents and patients with DM. There was correlative dependence between the level of glycated hemoglobin and parameter «school function» of quality of life. Administration of insulin analogs improves some indices of adolescents’ with DM quality of life. Estimation of it is one of the main criteria of treatment effectiveness. Key words: children, adolescents, insulin, diabetes type 1, quality of life. ( Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5): 14-18 )

The increase of morbidity with diabetes mellitus (DM) in children and adolescents during last years, and absence of adequate control of disease reveal the need of complex study of quality of life in these patients. The article presents the results of evaluation of quality of life rates, obtained with Russian versions of questionnaires PedsQL 4.0 Generic Core Scale and Diabetic Module in children and adolescents with diabetes type I, treated with different combinations of insulin drugs. The results showed that quality of life differs between group of healthy adolescents and patients with DM. There was correlative dependence between the level of glycated hemoglobin and parameter «school function» of quality of life. Administration of insulin analogs improves some indices of adolescents’ with DM quality of life. Estimation of it is one of the main criteria of treatment effectiveness.Key words: children, adolescents, insulin, diabetes type 1, quality of life.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):14-18)