Yasemin KARAL, Serap Tevhide KARASALİHOĞLU, Nilda TURGUT, Cevat Naci ÖNER, Filiz TÜTÜNCÜLER

Tip 1 Diabetes Mellituslu Çocuklarda Uyarılmış Potansiyellerin Eş Zamanlı Kan Şekeri, Serum ve Hücre İçi Magnezyum Düzeyleri ve Glikozillenmiş Hemoglobin İle İlişkisi

Tip I Diabetes Mellitus çocukluk çağının ciddi komplikasyonlar ile seyreden kronik metabolik hastalıklarından biridir. Bu çalışmanın amacı Tip I Diabetes Mellituslu çocuklarda erken dönemde santral sinir sistemi tutulumunun uyarılmış potansiyeller aracılığıyla değerlendirilmesi ve metabolik değişikliklerle ilişkisini saptamaktır. Çalışmaya 5-14 yaş arasında 31 Tip I Diabetes Mellituslu ve aynı yaş ve cinsiyette 35 sağlam çocuk alındı. Olgulardan 8 saat açlık sonrası HbA1c, kan şekeri, serum ve hücre içi magnezyum düzeyleri için kan örnekleri alındı. Tüm olguların otoskopik muayeneleri, işitme testleri ve uyarılmış potansiyel ölçümleri yapıldı. Gruplar metabolik parametreler, diabet süresi ve uyarılmış potansiyeller açısından karşılaştırıldı. Çalışma grubunun HbA1c ve kan şekeri değerleri kontrol grubuna göre anlamlı düzeyde yüksek, serum Mg değerleri istatistiksel olarak anlamlı oranda düşük saptandı (p<0.001) Diabetik grubun görsel uyarılmış potansiyelleri ve işitsel uyarılmış potansiyellerinin anlamlı oranda bozulduğu saptandı (p<0.05). Her iki grup arasında duyusal uyarılmış potansiyel değerlerinde belirgin farklılık gözlenmedi (p>0.05). Diabetik gruptaki tüm bu etkilenmelerin serum ve hücre içi magnezyumu, eş zamanlı kan şekeri, diabet süresi ve HbA1c düzeyleri ile ilişkili olduğu bulundu (p<0.05). Çalışmamızda diabette santral sinir sistemi tutulumu uyarılmış potansiyeller aracılığı ile gösterilebilen en erken bulgu olabileceği saptanmıştır. Bu etkilenmenin nedenleri arasında eş zamanlı kan şekeri ve diabetin süresi kadar glikozillenmiş hemoglobin, serum ve hücre içi magnezyum düzeyleri önemli de önemli yer tutmaktadır. Bu nedenle uyarılmış potansiyeller ve kan magnezyum düzeyi ölçümlerinin HbA1c, kan şekeri ölçümlerinde olduğu gibi diabetin rutin takip programına alınması yararlı olacaktır.

Anahtar Kelimeler:

Diabetes Mellitus; Uyarılmış potansiyeller; Magnezyum

Evoked Potentials in Type 1 Diabetic Children and Their Relation with Synchronous Blood Glucose, Serum and İntracellular Magnesium and Glycosylated Haemoglobin Levels

Type I Diabetes Mellitus is a chronic disease associated with high morbidity and complications. The aim of this study was to evaluate central nervous system involvement by evoked potentials in diabetic children and identify the relation with metabolic disturbances. The study comprised of 31 Type I diabetic children with aged 5-14 years and 35 age and sex matched controls. Visual, brainstem auditory and somatosensory evoked potentials, otoacoustic emissions were recorded in all subjects. Metabolic control was evaluated in terms of glyceamia, glycosylated haemoglobin, serum and intracellular magnesium status. Groups were compared due to metabolic processes, disease duration and evoked potentials. In the diabetic group, serum glucose and HbA1c levels were higher and serum magnesium levels were lower (p<0.001). There were significant abnormalities in the latency values of visual evoked potentials and brainstem auditory evoked potential waves in the diabetic group (p<0.05). There was no statistical difference in somatosensory evoked potentials (p>0.05). The significant difference of the evoked potentials in the diabetic groups was highly related with HbA1c and serum and intracellular magnesium levels as well as blood glucose levels and duration of diabetes (p<0.05). In conclusion, central nervous system involvement, highly related with synchronous blood glucose, glycosylated haemoglobin, duration of diabetes, serum and intracellular magnesium levels may be the earliest complication in diabetes mellitus that can be detected by evoked potentials. We consider that serum and intracelluler magnesium levels and evoked potentials will be useful in the routine follow up of diabetes mellitus.

Keywords:

Diabetes Mellitus; Evoked potentials; Magnesium,

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