Russian Children's Clinical Hospital.
Endocrinology Research Centre.
Probl Endokrinol (Mosk). 2021 Oct 8;67(6):113-123. doi: 10.14341/probl12795.
Therapy for type 1 diabetes mellitus (T1DM) is still largely an unsolved clinical problem. Despite the introduction into clinical practice of modern insulin preparations, devices for its administration, as well as continuous monitoring of glucose levels, the goals of therapy are often not achieved. At the same time, the International Diabetes Federation (IDF) notes an increase in the prevalence and incidence of T1DM in children and adolescents in the world. The Federal Register of Diabetes Mellitus (FRDM) is a dynamically updated database of patients with diabetes, which allows assessing prevalence and incidence rates, achievement of glycemic control goals and the incidence of diabetes complications.
analyze the epidemiological data of T1DM (prevalence, morbidity) in children and adolescents (patients from birth to 18 years of age) in Moscow according to the FRSD data and to assess their dynamics, as well as the dynamics of achieving the goals of glycemic control and the incidence of T1DM complications in 2015-2020.
The object of the study is a sample from the database of the Moscow segment of the FRDM of a cohort of patients with type 1 diabetes under 18 years of age who were registered for the period 01.01.2015-01.01.2021. Epidemiological prevalence and incidence rates are calculated per 100,000 of the relevant population.
the number of children and adolescents with type 1 diabetes in Moscow as of 01.01.2021 was 4024 people (2962 children and 1062 adolescents). Over the period from 2015 to 2020, there was an increase in the prevalence of T1DM (possibly due to an increase in the quality of data registration in the FRSD) and a decrease in the incidence of both children and adolescents. There was also a decrease in the level of HbA1c and the proportion of patients with HbAc1> 8.0% among children with T1DM. Both children and adolescents with T1DM showed a decrease in the incidence of diabetic coma and ketoacidosis with a simultaneous increase in the incidence of severe hypoglycemia, as well as a decrease in the incidence of retinopathy and nephropathy. However, the incidence of neuropathy decreased among children and increased among adolescents.
The data obtained on the dynamic management of adolescents with T1DM are the basis for considering the development of a profile program for their dynamic observation, taking into account the need for psychological and social support for patients and their families.
1 型糖尿病（T1DM）的治疗仍然是一个未解决的临床难题。尽管现代胰岛素制剂、给药设备以及连续血糖监测已引入临床实践，但治疗目标往往无法实现。与此同时，国际糖尿病联合会（IDF）注意到全球儿童和青少年 T1DM 的患病率和发病率有所增加。联邦糖尿病登记册（FRDM）是一个动态更新的糖尿病患者数据库，可用于评估患病率和发病率、血糖控制目标的实现情况以及糖尿病并发症的发生情况。
根据 FRDM 数据分析莫斯科儿童和青少年（出生至 18 岁）T1DM（患病率、发病率）的流行病学数据，并评估其动态变化，以及 2015-2020 年血糖控制目标的实现和 T1DM 并发症的发生率。
本研究的对象是莫斯科 FRDM 数据库中一个 18 岁以下 1 型糖尿病患者队列的样本，这些患者的登记时间为 2015 年 1 月 1 日至 2021 年 1 月 1 日。每 10 万相关人群计算流行病学患病率和发病率。
截至 2021 年 1 月 1 日，莫斯科儿童和青少年 1 型糖尿病患者人数为 4024 人（2962 名儿童和 1062 名青少年）。2015 年至 2020 年间，T1DM 的患病率有所增加（可能是由于 FRSD 中数据登记质量的提高），儿童和青少年的发病率均有所下降。T1DM 患儿的 HbA1c 水平和 HbAc1＞8.0%的患者比例也有所下降。T1DM 儿童和青少年的糖尿病昏迷和酮症酸中毒发病率均有所下降，同时严重低血糖的发病率有所上升，视网膜病变和肾病的发病率有所下降。然而，儿童的周围神经病变发病率下降，青少年的发病率上升。
获得的青少年 1 型糖尿病动态管理数据为考虑制定他们的动态观察方案提供了依据，同时考虑到患者及其家庭的心理和社会支持需求。
