Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
Sci Rep. 2021 Jul 16;11(1):14614. doi: 10.1038/s41598-021-94194-5.
We evaluated trajectories of glycated hemoglobin (HbA1c) levels and body mass index z-scores (BMIz) for 5 years after diagnosis among Korean children and adolescents with type 1 diabetes (T1D) or type 2 diabetes (T2D) using the common data model. From the de-identified database of three hospitals, 889 patients < 15 years of age diagnosed with T1D or T2D (393 boys, 664 T1D patients) were enrolled. Diagnosis was defined as first exposure to antidiabetic drug at each center. Compared with T2D patients, T1D patients had lower BMIz at diagnosis (- 0.4 ± 1.2 vs. 1.5 ± 1.4, p < 0.001) and 3 months (- 0.1 ± 1.0 vs. 1.5 ± 1.5, p < 0.001), and higher HbA1c levels at diagnosis (10.0 ± 2.6% vs. 9.5 ± 2.7%, p < 0.01). After 3 months, HbA1c levels reached a nadir of 7.6% and 6.5% in T1D and T2D patients, respectively, followed by progressive increases; only 10.4% of T1D and 29.7% of T2D patients achieved the recommended HbA1c target (< 7.0%) at 60 months. T1D patients showed consistent increases in BMIz; T2D patients showed no significant change in BMIz during follow-up. Peri-pubertal girls with T1D had higher HbA1c and BMIz values. Achieving optimal glycemic control and preventing obesity should be emphasized in pediatric diabetes care.
我们使用通用数据模型评估了韩国儿童和青少年 1 型糖尿病（T1D）或 2 型糖尿病（T2D）患者确诊后 5 年内糖化血红蛋白（HbA1c）水平和体质指数 z 评分（BMIz）的变化轨迹。这项研究从三所医院的匿名数据库中纳入了 889 名年龄小于 15 岁的 T1D 或 T2D 患者（393 名男性，664 名 T1D 患者）。在每个中心，确诊均定义为首次使用抗糖尿病药物。与 T2D 患者相比，T1D 患者的诊断时 BMIz 较低（-0.4±1.2 比 1.5±1.4，p<0.001），3 个月时 BMIz 也较低（-0.1±1.0 比 1.5±1.5，p<0.001），诊断时的 HbA1c 水平较高（10.0±2.6%比 9.5±2.7%，p<0.01）。3 个月后，T1D 和 T2D 患者的 HbA1c 水平分别达到 7.6%和 6.5%的最低点，随后逐渐升高；仅 10.4%的 T1D 和 29.7%的 T2D 患者在 60 个月时达到 HbA1c 目标值（<7.0%）。T1D 患者的 BMIz 持续增加；T2D 患者在随访期间 BMIz 无明显变化。T1D 的青春期前女孩的 HbA1c 和 BMIz 值较高。在儿科糖尿病护理中，应强调实现最佳血糖控制和预防肥胖。
