Kim Min Sun, Lee Dae Yeol
Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.
Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Institute of Chonbuk National University Hospital, Jeonju, Korea.
J Korean Med Sci. 2017 Jun;32(6):985-991. doi: 10.3346/jkms.2017.32.6.985.
This study aimed to investigate the prevalence of glucosuria and the characteristics of diabetes in schoolchildren as detected by a school urine glucose screening program implemented from 2010 to 2013 in the Jeonbuk province area of Korea. A total of 110 children without known diabetes were analyzed. They were checked with an oral glucose tolerance test (OGTT) with other laboratory tests and their clinical data were collected. A total of 707,238 schoolchildren from a school population of 1,064,999 were screened for glucosuria. In total, over a 4-year period, 545 schoolchildren (0.077%) were positive for glucosuria on the second urine test. The prevalence of glucosuria was more common among middle and high schoolchildren than among elementary schoolchildren. Among 110 students who completed the OGTT to confirm diabetes, 40 were diagnosed with diabetes mellitus (DM); 39 children, type 2 diabetes mellitus (T2DM) and 1 child, slowly progressive insulin dependent diabetes mellitus (SPIDDM). The mean annual incidence of diabetes was 5.6 per 100,000 schoolchildren and adolescents. The subjects with diabetes diagnosed through the urine screening test showed minimal or no symptoms of diabetes. The students with diabetes were more likely to be woman and obese, and they have a higher body mass index, higher cholesterol, triglyceride, insulin, C-peptide, and fasting glucosuria values than the students with normal glucose tolerance. We identified 40 new cases of diabetes in the Korean schoolchildren with asymptomatic glucosuria on urine glucose screening. This finding shows that school urine glucose screening is a feasible and simple method for early detection of asymptomatic T2DM.
本研究旨在调查2010年至2013年在韩国全罗北道地区实施的学校尿糖筛查项目所检测出的学童中糖尿的患病率以及糖尿病的特征。共分析了110名无已知糖尿病的儿童。他们接受了口服葡萄糖耐量试验（OGTT）及其他实验室检查，并收集了他们的临床数据。在1,064,999名在校学生中，共有707,238名学童接受了糖尿筛查。在总共4年的时间里，545名学童（0.077%）在第二次尿检时尿糖呈阳性。糖尿的患病率在初中生和高中生中比在小学生中更为常见。在完成OGTT以确诊糖尿病的110名学生中，40名被诊断为糖尿病（DM）；39名儿童为2型糖尿病（T2DM），1名儿童为缓慢进展性胰岛素依赖型糖尿病（SPIDDM）。糖尿病的年均发病率为每10万名学童和青少年中有5.6例。通过尿筛查试验诊断出的糖尿病患者表现出极少或没有糖尿病症状。糖尿病学生更可能为女性且肥胖，与糖耐量正常的学生相比，他们的体重指数更高、胆固醇、甘油三酯、胰岛素、C肽和空腹尿糖值也更高。我们在韩国尿糖筛查中发现了40例无症状糖尿的学童糖尿病新病例。这一发现表明，学校尿糖筛查是早期发现无症状T2DM的一种可行且简单的方法。
