Sandhu Sukhbir K, Corbett Vickie M, Chepulis Lynne, Goldsmith John, Joseph Priya, Fraser Sonya K, McClintock Joanna M, Paul Ryan G
Paediatric Registrar, Waikato District Health Board, Hamilton.
Nurse Practitioner, Waikato District Health Board, Hamilton.
N Z Med J. 2020 Feb 21;133(1510):35-44.
To determine whether glycaemic control and the prevalence of microvascular complications in Waikato children/youth with type 1 diabetes (T1D) has changed since 2003.
A retrospective review was performed of clinical records of children and youth with T1D who were under the care of the Waikato Paediatric and Young Adult Diabetes Services between March 2016 and March 2017. Comparisons were made to published data from the same service in 2003.
Despite a more than two-fold increase in insulin-pump therapy since 2003, glycaemic control was not significantly improved in either children or youth. However, since 2003 there has been a significant reduction in the prevalence of diabetic retinopathy (24.6% vs 6.0%; P=0.003) and nephropathy (6.0% vs 25.4%; P=0.002), while symptomatic diabetic neuropathy remains rare. This reduction occurred despite a significant increase in obesity and hypertension, and no significant difference in the rates of dyslipidaemia or smoking.
There has been a marked reduction in microvascular complications in Waikato youth and young adults with type 1 diabetes, but the reasons for the reduction are not clear given there has been no significant improvements in glycaemic control.
确定自2003年以来怀卡托地区1型糖尿病（T1D）儿童/青少年的血糖控制情况及微血管并发症患病率是否发生了变化。
对2016年3月至2017年3月期间在怀卡托儿科及青年成人糖尿病服务中心接受治疗的T1D儿童和青少年的临床记录进行回顾性分析。并与该服务中心2003年公布的数据进行比较。
尽管自2003年以来胰岛素泵治疗增加了两倍多，但儿童和青少年的血糖控制均未得到显著改善。然而，自2003年以来，糖尿病视网膜病变的患病率显著降低（24.6%对6.0%；P=0.003），肾病患病率也显著降低（6.0%对25.4%；P=0.002），而有症状的糖尿病神经病变仍然罕见。尽管肥胖和高血压显著增加，血脂异常或吸烟率没有显著差异，但患病率仍有所下降。
怀卡托地区1型糖尿病青少年和青年成人的微血管并发症显著减少，但鉴于血糖控制没有显著改善，减少的原因尚不清楚。
