Comparative characteristics of the state of stress-regulatory systems in children with type 1 diabetes mellitus, who have experienced traumatic events of the war in Ukraine

Objective — to determine the nature of changes in the indicators of stress-­regulatory systems in children with type 1 diabetes mellitus (DM) during different periods of the war in Ukraine. Materials and methods. The study involved 161 patients with type 1 DM aged 9 to 18 years. All patients were examined and treated in the clinic of the Institute for Children and Adolescents Health Care of the NAMS of Ukraine. Two groups of patients were identified. The first group included 29 patients who were in the anti­terrorist operation zone (Donetsk and Luhansk regions) in 2014—2017. The second group consisted of 132 patients who were in Kharkiv and Kharkiv region from February 24, 2022 to June 2024. The levels of cortisol, malondialdehyde (MDA), glutathione peroxidase and superoxide dismutase activity were determined in blood serum. The serotonin content was assessed in whole blood. The ratio of cortisol to serotonin was calculated as the coefficient of adaptation and interaction of stress­activating and stress-limiting systems in the body. Results and discussion. It has been established that the indicators of stress-regulatory systems change in children and adolescents with type 1 DM under war conditions in Ukraine.The identified imbalance of stress-activating and stress­limiting systems depends on the period of examination and has gender characteristics. At the beginning of the war, activation of the stress-activating and stress-limiting systems is registered, which indicates sufficient compensatory and adaptive mechanisms of protection of these patients. It should be noted that boys with type 1 DM at the beginning of the war in Ukraine are characterized by a significant increase in the levels of cortisol, serotonin and MDA in blood serum. A high level of MDA in the absence of changes in the activity of antioxidant enzymes indicates the formation of oxidative stress in boys with type 1 DM. During the full-­scale Russian invasion of Ukraine, patients with type 1 DM showed a decrease in the activity of the stress-limiting system and high values of the adaptation coefficient. This results in the inability of the body’s adaptive and compensatory systems to respond adequately to negative factors. High levels of cortisol in combination with a decrease in serotonin levels can affect the function of the nervous system and become a predictor of mental disorders, such as post-­traumatic stress disorder. Conclusions. Children and adolescents with type 1 diabetes mellitus require special attention, support, and psychological assistance during and after wartime, taking into account chronic endocrine disease.