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儿科糖尿病联盟 1 型糖尿病新发病(NeOn)研究:诊断后一年 HbA1c 水平相关因素。

Pediatric Diabetes Consortium Type 1 Diabetes New Onset (NeOn) Study: factors associated with HbA1c levels one year after diagnosis.

机构信息

Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, 77030, USA.

出版信息

Pediatr Diabetes. 2014 Jun;15(4):294-302. doi: 10.1111/pedi.12061. Epub 2013 Jul 24.

Abstract

OBJECTIVE

To identify determinants of hemoglobin A1c (HbA1c) levels 1 yr after the diagnosis of type 1 diabetes (T1D) in participants in the Pediatric Diabetes Consortium (PDC) T1D New Onset (NeOn) Study.

RESEARCH DESIGN AND METHODS

Diabetes-specific as well as socioeconomic factors during the first year following diagnosis were analyzed in 857 participants (mean age 9.1 yrs, 51% female, 66% non-Hispanic White) not participating in an intervention study who had an HbA1c value at 12 months.

RESULT

Mean ± SD HbA1c at 1 yr was 62 ± 16 mmol/mol (7.8% ± 1.5). In univariate and multivariate analyses, clinical center, non-Hispanic White race, private health insurance, living with both parents, higher frequency of self-monitoring of blood glucose (SMBG), and lower insulin requirements were associated with lower HbA1c concentrations at 1 yr (p < 0.01). No association was found with gender, age, Tanner stage, body mass index (BMI), diabetic ketoacidosis (DKA) at onset, number of positive autoantibodies or HbA1c at onset, or number of visits to diabetes physician during the first year.

CONCLUSIONS

White race, higher socioeconomic status, two-parent household, more frequent SMBG, and low insulin requirements are associated with lower HbA1c concentration 1 yr after the onset of T1D in children.

摘要

目的

在儿科糖尿病联合会(PDC)T1D 新发病例(NeOn)研究中,确定 1 型糖尿病(T1D)诊断后 1 年血红蛋白 A1c(HbA1c)水平的决定因素。

研究设计和方法

在未参加干预研究且在 12 个月时有 HbA1c 值的 857 名参与者(平均年龄 9.1 岁,51%为女性,66%为非西班牙裔白人)中,分析了诊断后第一年的糖尿病特异性和社会经济因素。

结果

1 年时的平均 HbA1c ± SD 为 62 ± 16 mmol/mol(7.8% ± 1.5)。在单因素和多因素分析中,临床中心、非西班牙裔白人种族、私人医疗保险、与父母同住、更高的自我监测血糖(SMBG)频率以及较低的胰岛素需求与较低的 1 年 HbA1c 浓度相关(p<0.01)。性别、年龄、Tanner 分期、体重指数(BMI)、发病时的糖尿病酮症酸中毒(DKA)、阳性自身抗体数量或发病时的 HbA1c 水平、或发病后第一年看糖尿病医生的次数与 HbA1c 浓度均无关联。

结论

白人种族、较高的社会经济地位、双亲家庭、更频繁的 SMBG 和较低的胰岛素需求与儿童 T1D 发病后 1 年 HbA1c 浓度较低相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0806/3858510/49c912919119/nihms497831f1.jpg

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