2019冠状病毒病疫情期间儿童和青少年2型糖尿病的血糖控制及并发症
Glycemic control and complications of type 2 diabetes mellitus in children and adolescents during the COVID-19 outbreak.
作者信息
Oh Kyeong Eun, Kim Yu Jin, Oh Ye Rim, Kang Eungu, Nam Hyo-Kyoung, Rhie Young-Jun, Lee Kee-Hyoung
机构信息
Department of Pediatrics, Woori Children's Hospital, Seoul, Korea.
Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
出版信息
Ann Pediatr Endocrinol Metab. 2023 Dec;28(4):275-282. doi: 10.6065/apem.2244214.107. Epub 2023 Dec 31.
PURPOSE
This study aimed to investigate the impact of coronavirus disease 2019 (COVID-19) on type 2 diabetes mellitus (T2DM) in children and adolescents.
METHODS
Children and adolescents diagnosed with T2DM who visited the Korea University Hospital in 2019 and 2020 were retrospectively analyzed, including changes in body mass index (BMI)-standard deviation score (SDS), glycated hemoglobin (HbA1c), diabetes complications, and diabetes management from 2019 to 2020.
RESULTS
Patient mean age and disease duration were 15.48±2.15 and 2.56±1.51 years, respectively. Obese patients accounted for 70.6% of the study population. From 2019 to 2020, mean BMI-SDS (2.21±1.25 vs. 2.35±1.43, P=0.044), HbA1c level (6.5%±2.72% vs. 7.3%±3.70%, P<0.001), blood pressure (BP), total cholesterol, and non-high-density lipoprotein cholesterol level in all patients increased significantly. Obesity was an independent predictor of increased HbA1c (95% confidence interval, 1.071-50.384; P=0.042). HbA1c levels did not increase significantly in nonobese patients, whereas HbA1c (6.45%±2.30% vs. 7.20%±3.05%, P<0.001), BMI-SDS (2.88±0.75 vs. 3.08±0.98, P=0.045), diastolic BP (P=0.037), and total cholesterol values (P=0.019) increased in obese patients in 2020 compared to 2019.
CONCLUSION
During the COVID-19 outbreak, glycemic control and diabetic complications worsened in children and adolescents with T2DM, particularly in obese patients. Close monitoring for glycemic control and diabetic complications is necessary in children and adolescents with T2DM, especially those with obesity.
目的
本研究旨在调查2019冠状病毒病(COVID-19)对儿童和青少年2型糖尿病(T2DM)的影响。
方法
对2019年和2020年就诊于韩国大学医院的确诊为T2DM的儿童和青少年进行回顾性分析,包括2019年至2020年期间体重指数(BMI)标准差评分(SDS)、糖化血红蛋白(HbA1c)、糖尿病并发症及糖尿病管理的变化。
结果
患者的平均年龄和病程分别为15.48±2.15岁和2.56±1.51年。肥胖患者占研究人群的70.6%。2019年至2020年,所有患者的平均BMI-SDS(2.21±1.25 vs. 2.35±1.43,P=0.044)、HbA1c水平(6.5%±2.72% vs. 7.3%±3.70%,P<0.001)、血压(BP)、总胆固醇及非高密度脂蛋白胆固醇水平均显著升高。肥胖是HbA1c升高的独立预测因素(95%置信区间,1.071-50.384;P=0.042)。非肥胖患者的HbA1c水平无显著升高,而与2019年相比,2020年肥胖患者的HbA1c(6.45%±2.30% vs. 7.20%±3.05%,P<0.001)、BMI-SDS(2.88±0.75 vs. 3.08±0.98,P=0.045)、舒张压(P=0.037)及总胆固醇值(P=0.019)均升高。
结论
在COVID-19疫情期间,T2DM儿童和青少年的血糖控制及糖尿病并发症恶化,尤其是肥胖患者。对于T2DM儿童和青少年,尤其是肥胖者,有必要密切监测血糖控制和糖尿病并发症。