Aeppli Tim R J, Mahler Fiona L, Konrad Daniel
Department of Endocrinology and Diabetology, University Children's Hospital, Zurich, Switzerland.
Department of Clinical Psychology, University Children's Hospital, Zurich, Switzerland.
J Pediatr Endocrinol Metab. 2019 Sep 25;32(9):929-933. doi: 10.1515/jpem-2019-0152.
Background The main objective of this study was to compare future glycemic control in children diagnosed with type 1 diabetes mellitus (T1DM) at toddler age and preschool/school age. In addition, we aimed to examine risk factors known to be associated with future glycated hemoglobin A1c (HbA1c) levels in children diagnosed with T1DM. Methods This is a retrospective cohort study of 85 patients diagnosed with T1DM at toddler age (group 1; 0-2.9 years; n = 36) or preschool/school age (group 2; 5-6.9 years; n = 49) who were followed up at the University Children's Hospital in Zurich for at least 10 consecutive years or until the age of 15 years. Results The mean HbA1c level in the first year after diagnosis had a highly predictive value about glycemic control in the following 6 years. In addition, a longer duration of T1DM was associated with higher HbA1c values. HbA1c values did not differ significantly within 11 years after diagnosis between children in the two age groups. Neither was a difference found when comparing the two groups in respect to their chronological age, although a trend was noted (p = 0.09). This trend is very likely due to a longer duration of diabetes in group 1. Conclusions HbA1c level in the first year predicts glycemic control for the next 6 years and deterioration of HbA1c values can be noted with longer duration of T1DM. Moreover, our study demonstrated similar future glycemic control in patients diagnosed with T1DM at toddler age and preschool/school age.
背景 本研究的主要目的是比较幼儿期和学龄前/学龄期诊断为1型糖尿病（T1DM）的儿童未来的血糖控制情况。此外，我们旨在研究已知与T1DM患儿未来糖化血红蛋白A1c（HbA1c）水平相关的危险因素。方法 这是一项回顾性队列研究，研究对象为85例在幼儿期（第1组；0 - 2.9岁；n = 36）或学龄前/学龄期（第2组；5 - 6.9岁；n = 49）被诊断为T1DM的患者，他们在苏黎世大学儿童医院接受了至少连续10年的随访或直至15岁。结果 诊断后第一年的平均HbA1c水平对接下来6年的血糖控制具有高度预测价值。此外，T1DM病程较长与较高的HbA1c值相关。诊断后11年内，两个年龄组儿童的HbA1c值无显著差异。在按实足年龄比较两组时也未发现差异，尽管有一个趋势（p = 0.09）。这种趋势很可能是由于第1组的糖尿病病程较长。结论 第一年的HbA1c水平可预测未来6年的血糖控制情况，且随着T1DM病程延长可观察到HbA1c值恶化。此外，我们的研究表明，幼儿期和学龄前/学龄期诊断为T1DM的患者未来血糖控制情况相似。
