Allen C, Zaccaro D J, Palta M, Klein R, Duck S C, D'Alessio D J
Department of Preventive Medicine, Ophthalmology, University of Wisconsin Medical School, Madison 53705-2368.
Diabetes Care. 1992 Aug;15(8):980-7. doi: 10.2337/diacare.15.8.980.
A cohort (n = 277) was followed from diabetes diagnosis to evaluate longitudinal glycemic control, urinary C-peptide levels, and certain features of diabetes self-management.
Unselected cases with IDDM, who were less than 30 yr of age, were identified at diagnosis from a 28-county area in Wisconsin. Subjects were asked to submit blood every 4 mo for GHb testing, to report aspects of diabetes self-management every 6 mo, and to collect a 24-h urine specimen 4 mo after diagnosis.
In the 1st yr of diabetes, the rate of increase (0.23%/mo) in GHb was significant for the cohort (P less than 0.001) and for almost all age and sex subgroups. In the 2nd yr, there was no significant rate of increase for the cohort as a whole (P greater than 0.10). Adolescent males (10-19 yr of age) had a mean GHb level for year 2 higher than males of other age-groups and higher than female adolescents (P less than 0.001). Adolescent males had a significant rate of increase in GHb for year 2 (P = 0.02), unlike all other age and sex subgroups. Adolescents had higher initial 24-h urine C-peptide levels than children less than 10 yr of age (P less than 0.01). During the 2nd yr of diabetes, the percentage of adolescent males reporting three or more insulin injections/day was lower than any other subgroup.
These data-suggest that glycemic control stabilizes during the 2nd yr of IDDM, except in adolescent males, and that this may be due partly to aspects of self-management.
对一组队列（n = 277）从糖尿病诊断开始进行随访，以评估血糖的长期控制情况、尿C肽水平以及糖尿病自我管理的某些特征。
从威斯康星州28个县的区域中，识别出年龄小于30岁的未经选择的胰岛素依赖型糖尿病（IDDM）病例。受试者被要求每4个月提交血液进行糖化血红蛋白（GHb）检测，每6个月报告糖尿病自我管理的情况，并在诊断后4个月收集24小时尿液样本。
在糖尿病的第1年，该队列的GHb升高速率（0.23%/月）具有显著性（P < 0.001），几乎所有年龄和性别亚组均如此。在第2年，整个队列没有显著的升高速率（P > 0.10）。青少年男性（10 - 19岁）第2年的平均GHb水平高于其他年龄组的男性以及女性青少年（P < 0.001）。与所有其他年龄和性别亚组不同，青少年男性在第2年的GHb有显著升高速率（P = 0.02）。青少年的初始24小时尿C肽水平高于10岁以下儿童（P < 0.01）。在糖尿病的第2年，报告每天注射三次或更多次胰岛素的青少年男性百分比低于任何其他亚组。
这些数据表明，除青少年男性外，IDDM患者在第2年血糖控制趋于稳定，这可能部分归因于自我管理方面。
