Alissa Nouf, Alhumaidi Shahad, Alzaid Sarah, Aldibasi Omar, Alfaraidi Haifa, Almutair Angham
Pediatric Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, King Abdullah Specialized Children's Hospital, Riyadh, Saudi Arabia.
Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Pediatr Diabetes. 2024 Feb 9;2024:5529674. doi: 10.1155/2024/5529674. eCollection 2024.
Our aim is to evaluate the impact of initiating a specialized children's hospital and expanding the diabetes service for children with type 1 diabetes (T1D) on their glycemic control and on acute-diabetes-related complications over a 4-year follow-up period.
This was a retrospective cohort study that included children aged 1-16 years with T1D, diagnosed for at least 1 year, and treated with multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). The study period extended from January 1, 2016 to December 31, 2019. Outcomes included the trend of glycemic control measured by HgbA1c and acute-diabetes-related complications, such as hypoglycemia, hyperglycemia, and diabetic ketoacidosis (DKA), reflected by the number of emergency room (ER) visits. Additionally, the number of visits per patient per year was captured over the 4-year study period.
Four hundred ninety-nine patients with T1D were included in the study (48.9% female). The mean age was 13.4 years (±2.0) in the CSII group and 12.4 years (±2.2) in the MDI group. Three thousand nine hundred and six visits were reviewed, with 618 in the CSII group and 3,288 in the MDI group. The mean hemoglobin A1c (HgbA1c) for the whole cohort was 10.56% at the start of the study period in 2016 and dropped by 0.67% to a mean of 9.89% in 2019 (-value = 0.025). There was a 0.67% decline in the HgbA1c of the MDI group and a 0.47% decrease in the CSII group (=<0.001). The average number of clinic visits per patient per year increased from 2.6 in 2016 to 2.8 in 2019. ER visits slightly decreased throughout the 4-year period (-value = 0.46).
Increased accessibility of the diabetes care team to children and adolescents with T1D and their families, with more frequent contact with team members, contributes significantly to the improvement of glycemic control.
我们的目的是评估开设一家专业儿童医院并扩大1型糖尿病（T1D）儿童糖尿病服务，在4年随访期内对其血糖控制及急性糖尿病相关并发症的影响。
这是一项回顾性队列研究，纳入1至16岁、确诊T1D至少1年、采用多次每日注射（MDI）或持续皮下胰岛素输注（CSII）治疗的儿童。研究期从2016年1月1日至2019年12月31日。结局包括通过糖化血红蛋白（HgbA1c）测量的血糖控制趋势以及急性糖尿病相关并发症，如低血糖、高血糖和糖尿病酮症酸中毒（DKA），通过急诊室（ER）就诊次数反映。此外，在4年研究期内记录了每位患者每年的就诊次数。
499例T1D患者纳入研究（48.9%为女性）。CSII组平均年龄为13.4岁（±2.0），MDI组为12.4岁（±2.2）。共审查了3906次就诊，CSII组618次，MDI组3288次。整个队列在2016年研究期开始时糖化血红蛋白（HgbA1c）平均为10.56%，2019年降至9.89%，下降了0.67%（P值=0.025）。MDI组HgbA1c下降0.67%，CSII组下降0.47%（P<0.001）。每位患者每年的门诊就诊平均次数从2016年的2.6次增加到2019年的2.8次。在整个4年期间急诊室就诊次数略有下降（P值=0.46）。
糖尿病护理团队增加与T1D儿童及青少年及其家庭的接触机会，更频繁地与团队成员联系，对改善血糖控制有显著贡献。
