Unidad de Endocrinología y Nutrición, Hospital General de Segovia, Segovia, Spain.
Servicio de Endocrinología y Nutrición, Hospital Universitario Central Asturias, Instituto de Investigación del Principado de Asturias, Oviedo, Asturias, Spain.
Endocrinol Diabetes Nutr (Engl Ed). 2021 Nov;68(9):642-653. doi: 10.1016/j.endien.2021.11.020. Epub 2021 Dec 3.
To determine the sociodemographic and clinical profile of a representative sample of people with type 1 diabetes mellitus (DM1) in Spain and identify factors associated with glycemic control.
A cross-sectional observational study was carried out in adults and children with DM1 treated in 75 Spanish public hospitals, geographically distributed in order to be representative of the Spanish population. Within each center, the patients were included on a consecutive basis as they visited the clinic. They were interviewed, and their clinical histories were reviewed. A descriptive statistical analysis was made, and factors associated with HbA were analysed using multivariate linear regression analysis.
A total of 647 patients were included: 55.3% females, aged 36.6 ± 14.4 years, 97.2% Caucasians, BMI 24.7 ± 4.4 kg/m (12.1% ≥ 30 kg/m), and 74.0% had secondary / university education. A total of 20.2% were active smokers. The mean time from the diagnosis of DM1 was 17.9 ± 12.0 years. A total of 48.7% presented comorbidities: 19.3% retinopathy and 16.4% hypothyroidism. As regards treatment for DM1, 76.5% received basal-bolus insulin therapy and 20.7% continuous subcutaneous insulin infusion (CSII); 51.0% of the patients used an insulin/carbohydrate ratio (ICR), with 4.6 ± 1.6 self-monitored capillary blood glucose (SMCBG) measurements a day, and 24.8% used continuous glucose monitoring (CGM). The mean HbA value was 7.6 ± 1.1% (30% below 7%). Metabolic control improved (lower HbA) with more daily SMCBG (B = -0.053; p = 0.009), a higher educational level (B = 0.461; P < 0.001), greater number of hypoglycemia episodes (B = -0.253; P = 0.018) and carbohydrate counting (B = -0.190; P = 0.048), and worsened the longer the duration of the disease (B = 0.010; P = 0.010), higher total dose of insulin (B = 0.010; P < 0.0001), poorer adherence to diet (B = 0.650; P < 0.0001) and a family history of DM (B = -0.233; P = 0.007).
The management of patients with DM1 in Spain, as well as the treatment they receive, is similar to that seen in other Western countries. Blood glucose control is associated with educational level, disease duration, and the characteristics of treatment and self-care.
确定西班牙 1 型糖尿病（DM1）患者的代表性样本的社会人口学和临床特征，并确定与血糖控制相关的因素。
在西班牙 75 家公立医院中对 DM1 进行治疗的成人和儿童中进行了一项横断面观察性研究。在每个中心，都按照患者就诊的顺序连续纳入患者。对他们进行访谈并查阅其病历。进行描述性统计分析，并使用多元线性回归分析分析与 HbA 相关的因素。
共纳入 647 例患者：55.3%为女性，年龄 36.6±14.4 岁，97.2%为白种人，BMI 为 24.7±4.4kg/m（12.1%≥30kg/m），74.0%接受过中学或大学教育。20.2%为主动吸烟者。从 DM1 诊断到现在的平均时间为 17.9±12.0 年。共有 48.7%的患者存在合并症：19.3%患有视网膜病变，16.4%患有甲状腺功能减退症。在 DM1 的治疗方面，76.5%的患者接受基础-餐时胰岛素治疗，20.7%的患者接受持续皮下胰岛素输注（CSII）；51.0%的患者使用胰岛素/碳水化合物比值（ICR），每天进行 4.6±1.6 次自我监测毛细血管血糖（SMCBG）测量，24.8%的患者使用连续血糖监测（CGM）。平均 HbA 值为 7.6±1.1%（30%低于 7%）。随着每日 SMCBG（B=−0.053；p=0.009），更高的教育水平（B=0.461；P<0.001），更多的低血糖发作次数（B=−0.253；P=0.018）和碳水化合物计数（B=−0.190；P=0.048）的增加，代谢控制得到改善（HbA 值降低），同时疾病持续时间（B=0.010；P=0.010）更长，胰岛素总剂量（B=0.010；P<0.0001）更高，饮食依从性更差（B=0.650；P<0.0001）和有糖尿病家族史（B=−0.233；P=0.007）。
西班牙 1 型糖尿病患者的管理以及他们接受的治疗与其他西方国家相似。血糖控制与教育水平、疾病持续时间以及治疗和自我护理的特点有关。
