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Evaluation of bladder dysfunction in children and adolescents with type 1 diabetes mellitus by uroflowmetry
Asan Onder Camas1, Şeyhmus Kerem Özel2, Zümrüt Kocabey Sütçü1
1Pediatric Endocrinology Clinic, Medeniyet University Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey.
Insights
Diabetic cystopathy, a bladder issue in type 1 diabetes mellitus, was assessed using uroflowmetry in children. Bladder dysfunction was observed in some patients, highlighting the need for monitoring autonomic function.
Area of Science:
- Pediatric Endocrinology
- Urology
- Diabetology
Background:
- Diabetic cystopathy is a complication of diabetes mellitus, affecting bladder function.
- It is characterized by decreased bladder sensitivity, increased capacity, reduced contractility, and elevated residual urine.
- It can serve as an early indicator of autonomic dysfunction.
Purpose of the Study:
- To evaluate bladder functions using uroflowmetry in children and adolescents diagnosed with type 1 diabetes mellitus.
- To identify the prevalence of voiding dysfunction in this pediatric population.
Main Methods:
- Uroflowmetry and post-void residual urine volume measurements were performed on pediatric patients with type 1 diabetes mellitus.
- Patient data, including physical examination findings and diabetes control laboratory results (HbA1c), were collected from clinical records.
Main Results:
- The study included 51 participants aged 72-216 months with a mean diabetes duration of 66.5 months and an average HbA1c of 9.7%.
- Urodynamic evaluation revealed normal bladder function in 70.6% of participants, while 29.4% exhibited voiding dysfunction.
- No significant differences in age, gender, diabetes duration, or metabolic control were found between those with and without voiding dysfunction.
Conclusions:
- Regular monitoring for autonomic dysfunction is crucial in patients with type 1 diabetes mellitus.
- Diabetic bladder dysfunction can occur independently of diabetes duration and metabolic control.
- Urodynamic evaluation is valuable for detecting bladder dysfunction and preventing potential complications in diabetic pediatric patients.
Objectives:
Diabetic cystopathy is a condition characterized by decreased bladder sensitivity, increased bladder capacity, decreased bladder contractility and increased residual urine volume. It can also be considered as an early indicator of autonomic dysfunction. In this study, it was aimed to evaluate bladder functions by uroflowmetry in children and adolescents with the diagnosis of type 1 diabetes mellitus.
Methods:
Type 1 diabetes mellitus children and adolescents were applied uroflowmetry and post-void residual urine volumes were evaluated. The physical examination findings of the patients and the laboratory data of diabetes control were obtained from the clinic files.
Results:
A total of 51 cases aged 72-216 (155.6 ± 35.4) months were enrolled into the study. Diabetes age of the cases was 66.5 ± 46.2(13-180) months. The last one year average of HbA1c of the patients was found to be 9.7 ± 1.9%. A total of 9.8% had good, 39.2% moderate and 51% poor metabolic control, respectively. While urodynamic evaluation was normal in 36 (70.6%) of 51 participants, voiding dysfunction was found in 15. There was no statistically significant difference between groups with and without voiding dysfunction in terms of age, gender, duration of diabetes, metabolic control and HbA1c values.
Conclusions:
It is very important to follow up patients with type 1 diabetes mellitus in terms of autonomic dysfunction. Diabetic bladder clinic, which can be observed independently of diabetes duration and metabolic control, is also included in this status. Urodynamic evaluation will be helpful both in demonstrating bladder dysfunction and in preventing possible complications.
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