Bathurst Rural Clinical School (BRCS), School of Medicine, Western Sydney University, Bathurst, NSW 2795, Australia.
African Vision Research Institute (AVRI), School of Optometry, University of KwaZulu Natal, Westville, Durban 3629, South Africa.
Nutrients. 2024 Nov 4;16(21):3779. doi: 10.3390/nu16213779.
Australian children with diabetes commonly struggle to achieve optimal glycaemic control, with minimal improvement observed over the past decade. The scarcity of research in the rural and regional Australian context is concerning, given high incidence rates and prominent barriers to healthcare access in these areas. We conducted a retrospective audit of 60 children attending a regional Australian paediatric diabetes service between January 2020 and December 2023. The majority of patients had type 1 diabetes ( = 57, 95.0%); approximately equal numbers were managed with continuous subcutaneous insulin infusion (CSII) pumps vs. multiple daily injections (MDIs), whilst 88.3% ( = 53) also utilised continuous glucose monitoring (CGM). The mean age at last visit was 14.0 years (SD, 3.4), mean diabetes duration 5.8 years (SD, 4.6), and mean HbA1c level 8.1% (65.3 mmol/mol); only 36.8% achieved the national target of 7.5% (58 mmol/mol). Mean BMI-SDS was 0.8 (SD, 1.0); almost half ( = 27, 45.0%) were overweight or obese. Many patients had mental health conditions (31.7%), which were associated with higher hospitalisation rates ( = 0.007). The attendance rate was 83.2%, with a mean of 3.3 clinic visits per year (SD, 0.7); higher attendance rates were associated with increased CGM sensor usage (r = 0.395, = 0.007 Overall, the diabetes service performed similarly to other clinics with regards to glycaemic control. Whilst achieving treatment targets and addressing comorbidities remains a challenge, the decent attendance and the high uptake of healthcare technologies is commendable. Further efforts are needed to improve diabetes management for this regional community.
澳大利亚的儿童糖尿病患者通常难以达到最佳血糖控制，过去十年观察到的改善甚微。鉴于这些地区糖尿病发病率高且医疗保健获取存在突出障碍，农村和地区澳大利亚背景下的研究稀缺令人担忧。我们对 2020 年 1 月至 2023 年 12 月期间在一家澳大利亚地区儿科糖尿病服务就诊的 60 名儿童进行了回顾性审计。大多数患者患有 1 型糖尿病（=57，95.0%）；使用持续皮下胰岛素输注（CSII）泵与多次每日注射（MDI）的患者数量大致相等，而 88.3%（=53）也使用连续血糖监测（CGM）。末次就诊时的平均年龄为 14.0 岁（标准差，3.4），平均糖尿病病程为 5.8 年（标准差，4.6），平均 HbA1c 水平为 8.1%（65.3mmol/mol）；仅 36.8%达到国家目标 7.5%（58mmol/mol）。平均 BMI-SDS 为 0.8（标准差，1.0）；几乎一半（=27，45.0%）超重或肥胖。许多患者有心理健康状况（31.7%），这与更高的住院率相关（=0.007）。就诊率为 83.2%，平均每年就诊 3.3 次（标准差，0.7）；更高的就诊率与增加 CGM 传感器使用率相关（r=0.395，=0.007）。总体而言，该糖尿病服务在血糖控制方面与其他诊所表现相似。虽然实现治疗目标和解决合并症仍然是一个挑战，但良好的就诊率和高使用率的医疗保健技术值得称赞。需要进一步努力改善该地区社区的糖尿病管理。
