The prediction of the development of diabetic myopathy in children with type 1 diabetes mellitus

Abstract

Background. The purpose was to determine the frequency, risk factors of the development of diabetic myopathy in children with type 1 diabetes mellitus (DM1), and to create a ma­thematical model for predicting the formation of pathology. Materials and methods. The observation group consisted of 136 children with DM1. All children underwent a comprehensive clinical, instrumental, and laboratory examination and assessment of the state of skeletal muscles to determine the risk factors for the development of diabetic myopathy. The prognostic significance of individual signs as risk factors of the development of diabetic myopathy in children with DM1 was analyzed based on calculating the relative risk (RR) index. The most significant factors included informative signs with an RR value of more than 1.0. The binary logistic regression method was used to predict the likelihood of developing diabetic myopathy. Results. The complex study showed that the development of diabetic myopathy took place in 45 (33.1 %) children. Based on the calculation of the RR index, out of 29 potential predictors, 7 risk factors were selected that can influence the development of diabetic myopathy: sex, age, duration of the disease, glycated hemoglobin level, fat mass index (FMI), ankle-brachial index, and the presence of peripheral neuropathy. A logistic regression model was constructed for individual prediction of the likelihood of developing diabetic myopathy. The classification model capacity was 90.2 %. The model sensitivity and specificity is 80.0 %, which characterizes the excellent quality of the classification of predictors and the high significance of the identified factors of the development of diabetic ­myopathy in children with DM1. Conclusions. Diabetic myopathy is a common complication of diabetes mellitus in children and develops in 33.1 % of cases. The priority contribution of the development of diabetic myopathy in children with DM1 is the state of glycemic control, the duration of diabetes mellitus, the patient’s age, sex, the presence of diabetic peripheral polyneuropathy, peripheral circulatory disorders, and an increase in the IMF. The developed mathematical forecasting model allows calculating with a high probability of developing diabetic myopathy in children with diabetes mellitus and can be used to identify patients with a high risk of developing this complication for the timely implementation of diagnostic and preventive management.

Keywords

• children, type 1 diabetes mellitus, diabetic myopathy, prediction