Petitti Diana B, Klingensmith Georgeanna J, Bell Ronny A, Andrews Jeanette S, Dabelea Dana, Imperatore Giuseppina, Marcovina Santica, Pihoker Catherine, Standiford Debra, Waitzfelder Beth, Mayer-Davis Elizabeth
Biomedical Informatics, Arizona State University, Phoenix, AZ, USA.
J Pediatr. 2009 Nov;155(5):668-72.e1-3. doi: 10.1016/j.jpeds.2009.05.025. Epub 2009 Jul 29.
To assess correlates of glycemic control in a diverse population of children and youth with diabetes.
This was a cross-sectional analysis of data from a 6-center US study of diabetes in youth, including 3947 individuals with type 1 diabetes (T1D) and 552 with type 2 diabetes (T2D), using hemoglobin A(1c) (HbA(1c)) levels to assess glycemic control.
HbA(1c) levels reflecting poor glycemic control (HbA(1c) >or= 9.5%) were found in 17% of youth with T1D and in 27% of those with T2D. African-American, American Indian, Hispanic, and Asian/Pacific Islander youth with T1D were significantly more likely to have higher HbA(1c) levels compared with non-Hispanic white youth (with respective rates for poor glycemic control of 36%, 52%, 27%, and 26% vs 12%). Similarly poor control in these 4 racial/ethnic groups was found in youth with T2D. Longer duration of diabetes was significantly associated with poorer glycemic control in youth with T1D and T2D.
The high percentage of US youth with HbA(1c) levels above the target value and with poor glycemic control indicates an urgent need for effective treatment strategies to improve metabolic status in youth with diabetes.
评估不同类型糖尿病儿童和青少年群体中血糖控制的相关因素。
这是一项对美国一项6中心青少年糖尿病研究数据的横断面分析，该研究纳入了3947例1型糖尿病（T1D）患者和552例2型糖尿病（T2D）患者，使用糖化血红蛋白A1c（HbA1c）水平评估血糖控制情况。
在1型糖尿病青少年中，17%的患者HbA1c水平反映血糖控制不佳（HbA1c≥9.5%）；在2型糖尿病青少年中，这一比例为27%。与非西班牙裔白人青少年相比，非裔美国、美国印第安、西班牙裔以及亚裔/太平洋岛民的1型糖尿病青少年HbA1c水平显著更高（血糖控制不佳的比例分别为36%、52%、27%和26%，而非西班牙裔白人青少年为12%）。在2型糖尿病青少年中也发现这4个种族/族裔群体存在类似的血糖控制不佳情况。糖尿病病程较长与1型和2型糖尿病青少年较差的血糖控制显著相关。
美国青少年中HbA1c水平高于目标值且血糖控制不佳的比例很高，这表明迫切需要有效的治疗策略来改善糖尿病青少年的代谢状况。
