Department of Paediatric Endocrinology and Diabetes, Royal London Hospital, London, UK.
Diabet Med. 2013 Apr;30(4):495-501. doi: 10.1111/dme.12022.
We prospectively evaluated the effect of insulin intensification on glycaemic control and lipid levels in children and young persons with Type 1 diabetes in relation to ethnicity.
In the first 2 years of a 3-year observation period, as part of routine clinical care, 231 children and young persons (40% white, 28% South Asian, 32% black) from a single clinic were offered intensive insulin therapy. After 2 years, 222 were on intensive therapy and their data were compared between ethnic groups at the end of year 3.
We observed ethnic differences in HbA(1c) levels during the study [study beginning and end: white children and young persons 77 and 70 mmol/mol (9.2 and 8.6%) vs. South Asian 72 and 68 mmol/mol (8.7 and 8.4%) vs. black 83 and 79 mmol/mol (9.7 and 9.4%), P-value for ANCOVA = 0.007]. By study end, South Asians had the lowest HDL cholesterol (2.0 vs. 1.4 vs. 1.6 mmol/l, P-value = 0.03) and highest triglyceride levels (0.9 vs. 1.8 vs. 1.0 mmol/l, P-value = 0.001). In linear mixed modelling, after adjustment for socio-economic deprivation and other covariates: (1) black ethnicity was associated with poorer glycaemic control (P < 0.001) and (2) South Asian ethnicity was associated with higher triglyceride levels (P < 0.001), independent of HbA(1c).
The effect of insulin intensification on glycaemic control and lipid profile in children and young persons with Type 1 diabetes differs in relation to ethnic group.
我们前瞻性地评估了胰岛素强化治疗对不同种族的 1 型糖尿病儿童和青少年血糖控制和血脂水平的影响。
在为期 3 年的观察期的前 2 年中，作为常规临床护理的一部分，来自单一诊所的 231 名儿童和青少年（40%为白人，28%为南亚人，32%为黑人）接受了强化胰岛素治疗。2 年后，222 名患者接受了强化治疗，在第 3 年末，根据种族对其数据进行了比较。
在研究期间，我们观察到不同种族之间的 HbA(1c)水平存在差异[研究开始和结束时：白人儿童和青少年为 77 和 70 mmol/mol（9.2 和 8.6%），南亚人为 72 和 68 mmol/mol（8.7 和 8.4%），黑人为 83 和 79 mmol/mol（9.7 和 9.4%），ANCOVA 检验 P 值=0.007]。到研究结束时，南亚人的 HDL 胆固醇最低（2.0 比 1.4 比 1.6 mmol/L，P 值=0.03），甘油三酯水平最高（0.9 比 1.8 比 1.0 mmol/L，P 值=0.001）。在线性混合模型中，在校正社会经济剥夺和其他协变量后：（1）黑人种族与较差的血糖控制相关（P <0.001），（2）南亚种族与较高的甘油三酯水平相关（P <0.001），这与 HbA(1c)无关。
胰岛素强化治疗对 1 型糖尿病儿童和青少年的血糖控制和血脂谱的影响因种族而异。
