Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.
Department of Endocrinology, Nicklaus Children's Hospital, Miami, FL, USA.
J Pediatr Endocrinol Metab. 2023 Oct 19;36(12):1128-1132. doi: 10.1515/jpem-2023-0334. Print 2023 Dec 15.
Technology use has been shown to improve diabetes control, but minority youths tend to have low rates of technology use and exhibit suboptimal glycemic control. We examined the impact of continuous glucose monitors (CGM) and continuous subcutaneous insulin infusion (CSII) on glycemic control in a racial-ethnic minority cohort of children and adolescents with type 1 diabetes (T1D).
A cross-sectional study was conducted among 140 pediatric T1D patients seen at a multidisciplinary clinic. From January to November 2022, data on demographics and glycated hemoglobin (HbA) levels were collected. Patients were categorized as technology (CGM, CSII, or both) or non-technology users (finger stick meter (FS) and multiple daily injections (MDI)).
The majority identified as Hispanic (79 %) and had public health insurance (71 %). Sixty-nine percent used technology. Compared with non-technology users, technology users had significantly lower mean HbA levels (9.60 vs. 8.40 %, respectively) (p=0.0024), though no group (CGM + CSII, CGM + MDI, FS + CSII, and FS + MDI) achieved a mean HbA level of <7.0 %. Regarding minority status, no significant differences in mean HbA levels existed between Hispanics and Blacks in the CGM + MDI and FS + CSII groups (p=0.2232 and p=0.9224, respectively). However, there was a significant difference in mean HbA levels between Hispanic and Black non-technology users (9.19 vs. 11.26 %, respectively) (p=0.0385).
Technology users demonstrated better glycemic control than non-technology users. Further research is needed to investigate factors affecting glycemic control in minority youths with T1D.
已证实，技术的使用能够改善糖尿病的控制，但少数族裔青少年的技术使用率往往较低，且血糖控制情况不佳。我们在一个患有 1 型糖尿病（T1D）的少数族裔青少年队列中，研究了连续血糖监测仪（CGM）和连续皮下胰岛素输注（CSII）对血糖控制的影响。
我们进行了一项横断面研究，纳入了在一个多学科诊所就诊的 140 名儿科 T1D 患者。在 2022 年 1 月至 11 月期间，收集了人口统计学和糖化血红蛋白（HbA）水平的数据。患者分为技术（CGM、CSII 或两者兼有）或非技术使用者（指尖血糖仪（FS）和多次每日胰岛素注射（MDI））。
大多数患者为西班牙裔（79%），并拥有公共医疗保险（71%）。69%的患者使用了技术。与非技术使用者相比，技术使用者的平均 HbA 水平显著更低（分别为 9.60 和 8.40%）（p=0.0024），但没有任何一组（CGM+CSII、CGM+MDI、FS+CSII 和 FS+MDI）的平均 HbA 水平达到<7.0%。就少数族裔身份而言，在 CGM+MDI 和 FS+CSII 组中，西班牙裔和非裔美国人的平均 HbA 水平没有显著差异（p=0.2232 和 p=0.9224）。然而，在非技术使用者中，西班牙裔和非裔美国人的平均 HbA 水平有显著差异（分别为 9.19 和 11.26%）（p=0.0385）。
技术使用者的血糖控制情况优于非技术使用者。需要进一步研究来调查影响 T1D 少数族裔青少年血糖控制的因素。
