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10岁以下儿童糖尿病的部分缓解期

Partial remission phase of diabetes in children younger than age 10 years.

作者信息

Muhammad B J, Swift P G, Raymond N T, Botha J L

机构信息

The Children's Hospital, Leicester Royal Infirmary, Leicester LE1 5WW, UK.

出版信息

Arch Dis Child. 1999 Apr;80(4):367-9. doi: 10.1136/adc.80.4.367.

Abstract

There is renewed interest in the phase of partial remission in recently diagnosed diabetes because of the potential for pharmacological and immune intervention to preserve beta cell function. 95 children younger than 10 years were investigated to assess the influence of age, sex, diabetic ketoacidosis (DKA), admission at diagnosis, and ethnicity on the frequency of remission and insulin requirements during the first two years after diagnosis. Partial remission was defined as a requirement of insulin < 0.5 U/kg body weight/day. There was partial remission in 41 patients, with no differences for children aged 2-4 years and those aged 5-9 years. None of the five children aged < 2 years remitted. Forty five of 95 children were admitted to hospital at diagnosis, of whom 26 of 45 had DKA (blood pH < 7.25). In this number of children we were unable to show a statistical difference in the rate of remission with respect to DKA, admission to hospital at diagnosis, sex, or South Asian ethnic background. There were no differences in insulin requirements between the different groups by the end of two years and at that time seven of the children required insulin < 0.5 U/kg/day. The results suggest that even in preschool children there is potential for attempting to preserve beta cell function.

摘要

由于药物和免疫干预在保留β细胞功能方面具有潜力,近期诊断出糖尿病的患者对部分缓解阶段重新产生了兴趣。对95名10岁以下儿童进行了调查,以评估年龄、性别、糖尿病酮症酸中毒(DKA)、诊断时入院情况以及种族对诊断后前两年缓解频率和胰岛素需求的影响。部分缓解定义为胰岛素需求量<0.5 U/(kg体重·天)。41例患者出现部分缓解,2至4岁儿童与5至9岁儿童之间无差异。2岁以下的5名儿童均未缓解。95名儿童中有45名在诊断时入院,其中45名中有26名患有DKA(血pH<7.25)。在这些儿童中,我们未能显示出缓解率在DKA、诊断时入院、性别或南亚种族背景方面存在统计学差异。到两年结束时,不同组之间的胰岛素需求无差异,此时有7名儿童的胰岛素需求量<0.5 U/(kg·天)。结果表明,即使在学龄前儿童中,尝试保留β细胞功能也是有可能的。

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本文引用的文献

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Effect of genetic risk load defined by HLA-DQB1 polymorphism on clinical characteristics of IDDM in children.
Eur J Clin Invest. 1995 Feb;25(2):106-12. doi: 10.1111/j.1365-2362.1995.tb01534.x.
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Postinitial remission in diabetic children--an analysis of 178 cases.
Acta Paediatr Scand. 1982 Nov;71(6):901-8. doi: 10.1111/j.1651-2227.1982.tb09546.x.
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