Aim. The aim of the study was to diagnose and study the severity of impaired adaptive capacity in children with insulin-dependent diabetes mellitus using the method of assessment of time intervals. Material and methods. The study included 54 adolescents, aged 14 to 18 years. 27 adolescents with type I diabetes mellitus, who were urgently hospitalized in the intensive care unit in a serious condition, constituted the study group, the other 27 adolescents who were hospitalized for planned surgical intervention constituted the control group (conditionally healthy children). The diagnosis of type I diabetes mellitus was confirmed by clinical and laboratory data (hyperglycemia, ketoacidosis, impaired level of consciousness (deafening-sore). Study protocol: psychophysiological testing in adolescents was performed using the original «Rhythm» program, which presented patients with a reference sequence of sound signals and pauses between them, after which the patients played back the sound sequence using a personal computer. Adolescents in the study group were tested after diabetic ketoacidosis had subsided, glycemia had stabilized, and the level of consciousness had normalized (3–5 days after admission). The control group was tested upon admission to thehospital for planned treatment. Significance of the total index of deviations from the specified reference was determined using Student’s t-criterion. Results and discussion. Significant adaptation disorders were detected both in the study group and in the control group. However, in children with diabetes mellitus these disorders were more pronounced due to a greater shortening of the total duration of the cycle, as well as a greater aggregate index of deviations from the duration of set signals and pauses as compared to the «reference standard». Conclusion. The findings support the hypothesis that impaired adaptation mechanisms as a manifestation of desynchronization of biological rhythms may lie in the mechanism of insulin-dependent diabetes mellitus development.
A Rare Case of Hypoglycemic Unawareness in a Patient With Chronic Congestive Heart Failure