Starship Children’s Hospital, Auckland District Health Board, Auckland, New Zealand.
Pediatr Diabetes. 2012 Jun;13(4):294-300. doi: 10.1111/j.1399-5448.2012.00851.x.
The incidence of type 2 diabetes mellitus (T2DM) is increasing in adolescents in most western countries. The time-course of glycemic control and impact of early treatment remain poorly understood.
To determine the change in incidence of T2DM, and the time-course of glycemic control in a regional pediatric cohort with T2DM.
Retrospective analysis of prospectively collected data on 52 patients with T2DM from a population-based treatment referral cohort from 1 January 1995 to 31 December 2007.
The annual incidence of new cases of T2DM in children <15 yr increased fivefold in the Auckland region of New Zealand from 1995 [0.5/100,000; 95% confidence interval (CI) 0.0–2.2] to 2007 (2.5/100,000; 95% CI 1.0–5.5). The average annual incidence per 100,000 over the entire period was 1.3 (95% CI 1.0–1.8) overall, 0.1 (0.0–0.4) in Europeans, and 3.4 in both Maori (2.0–5.3) and Pacifica (2.2–5.0). Fifty-seven percent of children were symptomatic at presentation. Fifty-eight percent of patients were treated with insulin from diagnosis, most of whom were symptomatic (p = 0.003). Follow-up data were available for 48 patients with a mean of 2.4 yr. Although insulin therapy was associated with a greater fall in HbA1c values in the first 12 months of treatment (to a nadir of 7.1 vs. 8.1%, p < 0.05), there was a rapid deterioration after 12 months, and subsequent mean HbA1c values were >9% in both groups. Therapy did not affect body mass index standard deviation score (BMI SDS).
The incidence of T2DM in childhood or adolescence increased markedly over a 13-yr period in the Auckland region. Long-
在大多数西方国家，2 型糖尿病（T2DM）的发病率在青少年中正在增加。血糖控制的时间进程和早期治疗的影响仍知之甚少。
确定在一个具有 T2DM 的区域性儿科队列中，T2DM 的发病率变化以及血糖控制的时间进程。
对 1995 年 1 月 1 日至 2007 年 12 月 31 日期间从一个基于人群的治疗转诊队列中前瞻性收集的数据进行了回顾性分析，该队列中共有 52 例 T2DM 患儿。
在新西兰奥克兰地区，1995 年儿童中新发 T2DM 的年发病率为 0.5/100,000（95%可信区间[CI]0.0–2.2），到 2007 年增至 2.5/100,000（95%CI1.0–5.5），增加了五倍。整个时期的平均每年每 100,000 人发病率为 1.3（95%CI1.0–1.8），其中欧洲人为 0.1（0.0–0.4），毛利人和太平洋岛民分别为 3.4（2.0–5.3）和 3.4（2.2–5.0）。57%的患儿就诊时有症状。从诊断开始，58%的患者接受胰岛素治疗，其中大多数（p = 0.003）有症状。48 例患者可获得平均 2.4 年的随访数据。虽然胰岛素治疗在治疗的前 12 个月内与 HbA1c 值的更大下降相关（降至 7.1%与 8.1%，p<0.05），但在 12 个月后迅速恶化，随后两组的平均 HbA1c 值均>9%。治疗并未影响体重指数标准差评分（BMI SDS）。
在奥克兰地区，13 年内儿童或青少年 T2DM 的发病率明显增加。
