Hsia Yingfen, Neubert Antje C, Rani Fariz, Viner Russell M, Hindmarsh Peter C, Wong Ian C K
Centre for Paediatric Pharmacy Research, The School of Pharmacy, University of London and The Institute of Child Health, University College London, London, UK.
Br J Clin Pharmacol. 2009 Feb;67(2):242-9. doi: 10.1111/j.1365-2125.2008.03347.x.
Increasing antidiabetic drugs use in youths has been reported in the USA, however there is a lack of epidemiological evidence in the UK. There is an increase in the prevalence of both type 1 and 2 diabetes, but precise estimates are difficult to obtain and as such are uninformative for future health services planning.
The prevalence of children receiving insulin and oral antidiabetic drugs has increased twofold and eightfold, respectively, between 1998 and 2005. The data reflect the prevalence of both type 1 and type 2 diabetes rapidly increase in recent years. The prevalence of antidiabetic drug use increases with increasing age, especially among those aged 12-18 years. Consideration needs to be given to the funding and design of future services for children and particularly adolescents with diabetes to take account of these epidemiological findings.
Despite evidence of an increase in the incidence of both type 1 and type 2 diabetes in youths, there are few data on the prevalence of either type in children and adolescents. The aim of this study was to investigate the prevalence of childhood diabetes over an 8-year period in the UK.
This was a retrospective cohort study that covered 8 years (January 1998 to December 2005) of UK IMS Disease Analyzer (IMS DA) data. The cohort comprised all children and adolescents aged 0-18 years who received at least one antidiabetic drug prescription during the study period. The prevalence of antidiabetic drug prescribing was used as a proxy for diabetes itself.
Data were available on 505 754 children aged 0-18 years and a total of 37 225 antidiabetic prescriptions were issued. Insulin use increased significantly from 1.08 per 1000 children [95% confidence interval (CI) 0.96, 1.20] in 1998 to 1.98 (95% CI 1.80, 2.10) in 2005 (P < 0.001), more markedly in those aged 12 and 18 years. The use of oral antidiabetic drugs for diabetes treatment rose significantly from 0.006 per 1000 children in 1998 (95% CI 0.0043, 0.017) to 0.05 (95% CI 0.025, 0.080) (P < 0.001) in 2005.
This study indicates a significant increase in prevalence on both type 1 and type 2 diabetes treatment in children and adolescents in the UK. Thus, this supporting evidence from other sources that the prevalence of childhood diabetes is rising rapidly. Further epidemiological studies are required to investigate the aetiology and risk factors.
美国已报道青少年抗糖尿病药物的使用在增加，然而在英国缺乏流行病学证据。1型和2型糖尿病的患病率均有所上升，但难以获得精确估计值，因此对于未来的卫生服务规划并无参考价值。
在1998年至2005年间，接受胰岛素治疗和口服抗糖尿病药物治疗的儿童患病率分别增长了两倍和八倍。这些数据反映出近年来1型和2型糖尿病的患病率都在迅速上升。抗糖尿病药物的使用患病率随年龄增长而增加，尤其是在12至18岁的人群中。需要考虑为患有糖尿病的儿童尤其是青少年提供未来服务的资金投入和规划设计，以顾及这些流行病学研究结果。
尽管有证据表明青少年中1型和2型糖尿病的发病率均在上升，但关于儿童和青少年中这两种类型糖尿病患病率的数据却很少。本研究的目的是调查英国8年间儿童糖尿病的患病率。
这是一项回顾性队列研究，涵盖了英国IMS疾病分析器（IMS DA）1998年1月至2005年12月这8年的数据。该队列包括在研究期间接受至少一张抗糖尿病药物处方的所有0至18岁儿童和青少年。抗糖尿病药物处方的患病率被用作糖尿病患病率的替代指标。
获取了505754名0至18岁儿童的数据，共开出了37225张抗糖尿病药物处方。胰岛素的使用量从1998年每1000名儿童中的1.08例[95%置信区间（CI）0.96，1.20]显著增加到2005年的1.98例（95%CI 1.80，2.10）（P<0.001），在12至18岁的人群中更为明显。用于糖尿病治疗的口服抗糖尿病药物的使用量从1998年每1000名儿童中的0.006例（95%CI 0.0043，0.017）显著上升至2005年的0.05例（95%CI 0.025，0.080）（P<0.001）。
本研究表明英国儿童和青少年中1型和2型糖尿病治疗的患病率显著上升。因此，这为其他来源的证据提供了支持，即儿童糖尿病的患病率正在迅速上升。需要进一步开展流行病学研究以调查其病因和风险因素。
