Biến chứng mạn tính và xác định tỷ lệ có chỉ định ghép tụy tạng ở người bệnh đái tháo đường típ 1 tại Bệnh viện Nội tiết Trung ương

Abstract

Objective: To describe the characteristics of chronic complications and the rate of pancreas transplantation indications in patients with type 1 diabetes mellitus (T1DM) examined and treated at the National Hospital of Endocrinology. Subject and method: 110 patients, regardless of age or gender, diagnosed with T1DM according to ADA 2022 criteria, who have not received a pancreas transplant, were examined and treated at the National Hospital of Endocrinology from January 2022 to January 2024. A cross-sectional descriptive study with analysis and evaluation. Result: 50/110 patients had diabetic retinopathy due to diabetes, accounting for 40.9%. Proliferative retinal lesions accounted for the majority of the group with diabetic retinopathy, accounting for 51.8%. 38/110 (34.5%) of T1DM patients in the study had diabetic nephropathy. The rate of patients with microalbuminuria was 52.6%, higher than that of the group with macroalbuminuria. 4/38 (10.4%) of patients with end-stage renal disease required hemodialysis. Older age, long duration of disease and hypertension were risk factors for increased rates of diabetic retinopathy and diabetic nephropathy in type 1 diabetic mellitus patients, the difference was statistically significant with p<0.05. The rates of macrovascular complications and autonomic nerve complications were 10% and 30.9%, respectively. There were 28/110 (25.5%) patients with indications for pancreas transplantation alone, 18/110 (16.4%) patients with indications for simultaneous pancreas-kidney transplantation. Only 04 cases of hemodialysis, accounting for 3.6%, required pancreas transplantation only after stable kidney transplantation. Conclusion: Diabetic retinopathy and diabetic nephropathy are the most common chronic complications in patients with type 1 diabetes mellitus. Age, duration of disease, and poor blood pressure control increase the risk of complications of the disease. In the treatment as well as improving prognosis, reducing chronic complications in patients with type 1 diabetes mellitus, pancreas transplantation is increasingly indicated.