Bach Christian Hospital, Qalandarabad, Abbottabad, Hazara, KPK, Pakistan.
Life for a Child Program, Diabetes NSW & ACT, Glebe, NSW 2037, Australia; NHMRC Clinical Trials Centre, University of Sydney, NSW 2006, Australia.
Diabetes Res Clin Pract. 2020 May;163:108155. doi: 10.1016/j.diabres.2020.108155. Epub 2020 Apr 22.
Determine the types, incidence, mortality rate, and clinical status of youth diabetes at Bach Christian Hospital (BCH), Qalandarabad, Pakistan.
Analysis of incidence and mortality data of all patients (<25 year (y)) diagnosed from January 2014-June 2019, and also analysis of clinical status of patients < 25y seen in 2018/2019.
Ninety-three patients were seen over the study period. Eighty-eight were type 1 diabetes (T1D), 51.1% female. Age of diagnosis was 0.8-24.5 years (y) (mean = 11.4 y, SD = 6.2y). 15.1% were 0-4y, 31.4% 5-9 y, 24.4% 10-14y, 19.8% 15-19y, and 9.3% 20-24y. Minimum incidence for the Mansehra tehsil administrative district was calculated as 1.0 per 100,000 population <15y/y, 1.2 per 100,000 < 20y/y and 1.1 per 100,000 < 25y/y; the degree of ascertainment could not be assessed. A further four patients were diagnosed with thiamine-responsive megaloblastic anaemia (TRMA), all male, three from the same consanguineous family, and were treated with high-dose thiamine. One other patient was diagnosed with type 2 diabetes. Three T1D and one TRMA patient died during the study period. The standardised mortality rate for T1D was 9.4, but vital status was unknown for 13 patients. The mean/median HbA1c of T1D patients seen in 2018/2019 was 9.1%/9.2% (76/77 mmol/mol).
Minimum T1D incidence in Mansehra tehsil is double the previously reported value for Pakistan (from 1990 to 1999), although is still low compared to most other countries. Considering the limited resources available, patients attending BCH are achieving fair glycemic control. The TRMA cases show the importance of genetic testing in atypical cases.
确定巴基斯坦 Qalandarabad 巴赫基督教医院（BCH）青年糖尿病的类型、发病率、死亡率和临床状况。
分析 2014 年 1 月至 2019 年 6 月期间所有<25 岁（y）患者的发病率和死亡率数据，并分析 2018/2019 年就诊的<25 岁患者的临床状况。
在研究期间共观察到 93 例患者。88 例为 1 型糖尿病（T1D），女性占 51.1%。诊断年龄为 0.8-24.5 岁（y）（平均 11.4 y，SD 6.2y）。15.1%为 0-4 岁，31.4%为 5-9 岁，24.4%为 10-14 岁，19.8%为 15-19 岁，9.3%为 20-24 岁。计算得出 Mansehra 行政区的最低发病率为每 10 万<15 岁以下人群 1.0 例/10 万人/年，每 10 万<20 岁以下人群 1.2 例/10 万人/年，每 10 万<25 岁以下人群 1.1 例/10 万人/年；无法评估发现程度。另外还有 4 例患者被诊断为硫胺素反应性巨幼细胞性贫血（TRMA），均为男性，其中 3 例来自同一近亲家庭，均接受大剂量硫胺素治疗。另一名患者被诊断为 2 型糖尿病。在研究期间，有 3 例 T1D 和 1 例 TRMA 患者死亡。T1D 的标准化死亡率为 9.4，但 13 名患者的生存状况不明。2018/2019 年就诊的 T1D 患者的平均/中位数 HbA1c 为 9.1%/9.2%（76/77 mmol/mol）。
曼色拉县的 T1D 最低发病率是巴基斯坦此前报告的（1990 年至 1999 年）的两倍，但与大多数其他国家相比仍较低。考虑到可用资源有限，BCH 就诊的患者血糖控制良好。TRMA 病例表明在非典型病例中进行基因检测的重要性。
