Ludwig Karissa, Craig Maria E, Donaghue Kim C, Maguire Ann, Benitez-Aguirre Paul Z
Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia.
Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Pediatr Diabetes. 2021 May;22(3):380-387. doi: 10.1111/pedi.13169. Epub 2020 Dec 21.
To assess the clinical and demographic characteristics of children and adolescents across Australia and New Zealand (NZ) with type 2 diabetes.
We performed a descriptive audit of data prospectively reported to the Australasian Diabetes Data Network (ADDN) registry. Data were collected from six tertiary pediatric diabetes centers across Australia (New South Wales, Queensland, South Australia, Western Australia, and Victoria) and NZ (Auckland). Children and adolescents diagnosed with type 2 diabetes aged ≤ 18 years with data reported to ADDN between 2012 and 2017 were included. Age, sex, ethnicity, HbA1c, blood pressure, BMI, waist circumference and lipid profile at first visit were assessed.
There were 269 cases of type 2 diabetes in youth reported to ADDN between 2012 and 2017. The most common ethnicities were Indigenous Australian in 56/243 (23%) and NZ Maori or Pacifica in 47 (19%). Median age at diagnosis was 13.7 years and 94% of participants were overweight or obese. Indigenous Australian and Maori/Pacifica children were younger at diagnosis compared with nonindigenous children: median 13.3 years (indigenous Australian); 13.1 years (Maori/Pacifica); 14.1 years (nonindigenous), p = 0.005. HbA1c was higher in indigenous Australian (9.4%) and Maori/Pacifica youth (7.8%) compared with nonindigenous (6.7%) p < 0.001. BMI-SDS was higher in Maori/Pacifica youth (2.3) compared with indigenous Australian (2.1) and nonindigenous (2.2) p = 0.011.
Indigenous Australian and Maori/Pacifica youth in ADDN were younger and had worse glycaemic control at diagnosis of type 2 diabetes. Our findings underscore the need to consider targeted and earlier screening in these "high-risk" populations.
评估澳大利亚和新西兰(NZ)2型糖尿病儿童及青少年的临床和人口统计学特征。
我们对前瞻性报告给澳大拉西亚糖尿病数据网络(ADDN)登记处的数据进行了描述性审核。数据收集自澳大利亚(新南威尔士州、昆士兰州、南澳大利亚州、西澳大利亚州和维多利亚州)和新西兰(奥克兰)的六个三级儿科糖尿病中心。纳入2012年至2017年间被诊断为2型糖尿病且年龄≤18岁并向ADDN报告数据的儿童及青少年。评估首次就诊时的年龄、性别、种族、糖化血红蛋白(HbA1c)、血压、体重指数(BMI)、腰围和血脂谱。
2012年至2017年间向ADDN报告的青少年2型糖尿病病例有269例。最常见的种族是56/243(23%)的澳大利亚原住民以及47例(19%)的新西兰毛利人或太平洋岛民。诊断时的中位年龄为13.7岁,94%的参与者超重或肥胖。与非原住民儿童相比,澳大利亚原住民和毛利人/太平洋岛民儿童诊断时年龄更小:中位数为13.3岁(澳大利亚原住民);13.1岁(毛利人/太平洋岛民);14.1岁(非原住民),p = 0.005。与非原住民(6.7%)相比,澳大利亚原住民(9.4%)和毛利人/太平洋岛民青少年(7.8%)的糖化血红蛋白更高,p < 0.001。与澳大利亚原住民(2.1)和非原住民(2.2)相比,毛利人/太平洋岛民青少年的BMI标准差分数(BMI-SDS)更高(2.3),p = 0.011。
ADDN中的澳大利亚原住民和毛利人/太平洋岛民青少年在诊断2型糖尿病时年龄更小,血糖控制更差。我们的研究结果强调了在这些“高危”人群中进行有针对性的早期筛查的必要性。