Сахарный диабет (Aug 2018)
Peculiarities of night EEG-monitoring of sleep in children with type 1 diabetes mellitus depending on the glycemia level
Abstract
BACKGROUND: The patterns of bioelectric activity of the brain in patients with type 1 diabetes mellitus are being actively studied. A recent study of changes in brain bioelectric activity during sleep in children with diabetes mellitus was done without monitoring changes in the level of glycaemia in real time. The current study was conducted with concurrent monitoring of EEG in sleep and glycaemia. AIM: To study the results of night time EEG monitoring of sleep in children with type 1 diabetes mellitus depending on the level of glycaemia. METHODS: This study included 20 children (10–17 years of age) with type 1 diabetes. All patients received continuous monitoring of glycaemia and night time EEG of sleep for 9 h. RESULTS: Absence of pathological changes was more often observed in patients with optimal glycaemic indices (n = 9) compared with patients with hypoglycaemic periods (n = 0) (P = 0.011, Fisher exact test) and hyperglycaemia (n = 3) (P = 0.0011, Fisher exact test). Light paroxysmal disturbances (high-amplitude bilateral flares during theta waves in stages 1–2 of sleep) were more often recorded in patients during periods of hypoglycaemia (n = 3) compared with periods of optimal glycaemia (n = 1) (P = 0.032, Fisher exact test). The hypersynchronous rhythm was also more often detected in patients during periods of hypoglycaemia (n = 3) compared with optimal glycaemia (n = 1) (P = 0.032, Fisher exact test). ECG potentials were more often recorded in hypoglycaemia (n = 4) compared with optimal glycaemia (n = 2) (P = 0.011, Fisher exact test) and hyperglycaemia (n = 3) (P = 0.005, Fisher exact test). The interrelation of brain bioelectric activity and glycaemic indices was seen in patients with hypoglycaemia (positive correlation) and at optimal glycaemia (negative correlation). The highest correlation was seen between ECG potentials (r = +0.61, P < 0.05), hypersynchronous rhythm (r = +0.40; P < 0.05) and hypoglycaemia. Significant differences between the groups were obtained in the beta range (increase in amplitude and beta-rhythm index) by the spectral analysis. CONCLUSIONS: Disturbance of the bioelectric activity of the brain is seen mainly in the hypoglycaemic state in patients with type 1 diabetes mellitus. This indicates the dysfunction of vegetative regulatory adaptation mechanisms, which can significantly increase the risk of severe hypoglycaemia.
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