Department of Paediatrics, Tampere University Hospital, Tampere, Finland.
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Endocrinol Diabetes Metab. 2023 Nov;6(6):e452. doi: 10.1002/edm2.452. Epub 2023 Sep 25.
Socioeconomic problems may present significant challenges when trying to reach optimal glycaemic control in paediatric patients with type 1 diabetes. We examined sociodemographic factors affecting metabolic control in patients in one of the biggest paediatric diabetes clinics in Finland.
One hundred ninety-one children (age 2-15 years; median 11 years; 47% female) with type 1 diabetes and their families were recruited during outpatient visits in the paediatric diabetes clinic of Tampere University Hospital, Finland. The participants completed a questionnaire on the family's sociodemographic background. The child's glycaemic control was assessed by both glycosylated haemoglobin (HbA1c) and time in range (TIR). Risk factors for poor (HbA1c ≥75 mmol/mol; TIR <40%) and optimal (HbA1c <53 mmol/mol; TIR ≥70%) metabolic control were searched using logistic regression analyses.
Living in a nuclear family, male gender, younger age and a school assistant for diabetes management were associated with the simultaneous presence of both indicators of optimal metabolic control. Poor glycaemic control, as estimated by HbA1c, was associated with lower parental education and the child's older age. Parental smoking and the child's older age were associated with poor TIR.
This study confirms the importance of sociodemographic factors in care of Finnish paediatric patients with type 1 diabetes. Sociodemographic status markers of the family could be used as triggers to alert paediatric diabetes teams to offer more tailored care to families with new-onset type 1 diabetes mellitus.
在试图达到 1 型糖尿病儿科患者的最佳血糖控制时,社会经济问题可能会带来重大挑战。我们研究了影响芬兰最大儿科糖尿病诊所之一的患者代谢控制的社会人口因素。
在芬兰坦佩雷大学医院儿科糖尿病诊所的门诊就诊期间,招募了 191 名(年龄 2-15 岁;中位数 11 岁;47%为女性)1 型糖尿病患儿及其家属。参与者完成了一份关于家庭社会人口背景的问卷。通过糖化血红蛋白(HbA1c)和时间在目标范围内(TIR)评估儿童的血糖控制情况。使用逻辑回归分析搜索了不良(HbA1c≥75mmol/mol;TIR<40%)和最佳(HbA1c<53mmol/mol;TIR≥70%)代谢控制的危险因素。
居住在核心家庭、男性、年龄较小和学校助理管理糖尿病与同时存在两种最佳代谢控制指标有关。较差的血糖控制(HbA1c 估计)与父母教育程度较低和儿童年龄较大有关。父母吸烟和儿童年龄较大与 TIR 较差有关。
本研究证实了社会人口因素在芬兰 1 型糖尿病儿科患者护理中的重要性。家庭的社会人口状况标志物可用作触发因素,提醒儿科糖尿病团队为新诊断的 1 型糖尿病患儿提供更具针对性的护理。