Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Pediatria, Ribeirão Preto, SP, Brazil.
Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Pediatria, Ribeirão Preto, SP, Brazil.
J Pediatr (Rio J). 2024 Mar-Apr;100(2):184-188. doi: 10.1016/j.jped.2023.10.003. Epub 2023 Nov 7.
Clinical-laboratory comparison of a population of children and adolescents with DM1 followed at a Brazilian outpatient university clinic, at two different periods (2014 and 2020), regarding changes made both to the insulin therapy scheme and to the nutritional approach to carbohydrate counting.
The data of patients with DM1 aged 0-19 years enrolled in the service in 2014 and 2020 were collected. Student's t-test was performed to compare the means of HbA1c and the variables of interest.
NPH + regular insulin was predominantly used in 2014 (49.1%), while in 2020, the predominance shifted to insulin analogs (48.4%). Pump use tripled from 1.3% in 2014 to 4.4% in 2020, and the percentage of patients performing carbohydrate counting reduced from 28.3% to 17.8%. Regarding HbA1c, the 2014 group of patients had a mean of 9.8%, while the 2020 group had a mean of 9.6% (p = 0.49).
The change in treatments between 2014 and 2020 did not result in a significant improvement in HbA1c levels. However, it was identified the importance of carbohydrate counting and the use of insulin analogs to improve metabolic control in this population at both times.
比较巴西一家门诊大学诊所的两个不同时期（2014 年和 2020 年）的 1 型糖尿病（DM1）患儿和青少年患者的临床实验室数据，以评估胰岛素治疗方案和碳水化合物计数营养方法的变化。
收集了该服务部门 2014 年和 2020 年登记的 0-19 岁 DM1 患者的数据。采用学生 t 检验比较 HbA1c 均值和感兴趣的变量。
2014 年，NPH+常规胰岛素（49.1%）被广泛使用，而在 2020 年，胰岛素类似物（48.4%）的使用占主导地位。胰岛素泵的使用率从 2014 年的 1.3%增加到 2020 年的 4.4%，进行碳水化合物计数的患者比例从 28.3%降至 17.8%。关于 HbA1c，2014 年组患者的平均水平为 9.8%，而 2020 年组患者的平均水平为 9.6%（p=0.49）。
2014 年至 2020 年期间治疗方法的改变并未导致 HbA1c 水平显著改善。然而，在这两个时期，都发现了碳水化合物计数和使用胰岛素类似物的重要性，这有助于改善该人群的代谢控制。
