Favel Kristen, Kelly Maryellen S, Lam Shing Tat Theodore, Bone Jeffrey N, Morgan Kathryn E, Stephany Heidi A, Thomas Sruthi, Afshar Kourosh, Panagiotopoulos Constadina
Division of Pediatric Nephrology, Department of Pediatrics, University of California San Francisco, San Francisco, California, USA.
Benioff Children's Hospital, San Francisco, California, USA.
Pediatr Diabetes. 2025 Aug 15;2025:5294835. doi: 10.1155/pedi/5294835. eCollection 2025.
Urologic complications, including urinary incontinence and urinary tract infections are commonly observed in the adult population with type 1 diabetes (T1D); however, there remains a paucity of data on the prevalence, associated risk factors and impact of bowel and bladder dysfunction (BBD) in the pediatric T1D population. This study aims to examine the prevalence of BBD in children with T1D compared to healthy pediatric controls and to explore clinical factors associated with childhood BBD. This cross-sectional, noninterventional, multicenter survey study involved children with TID and healthy controls aged 5-16 years across North America. Participants and their caregivers completed the Vancouver Symptom Score (VSS) to assess bowel and bladder symptoms. BBD was defined as a total VSS score of 11 or greater. Logistic regression was used to identify potential factors associated with BBD and bother with symptoms. In a group of 242 participants with T1D and 86 controls, 46% were male, and the median age was 11.0 years. The prevalence of BBD was found to be higher in participants with T1D at 21.5%, compared to 10.5% in controls. While irritative symptoms were most commonly reported in the T1D group with BBD, urinary incontinence caused the most bother. In the T1D group, poorer glycemic control was linked to a greater likelihood of BBD, while male sex and more severe symptomatology (such as urinary incontinence) were associated with greater bother related to these symptoms. There is a high prevalence of BBD in children with T1D compared to healthy controls. These data highlight the need for early identification and intervention for BBD in T1D. Proactive measures, such as routine screening and comprehensive T1D management with strict attention to glycemic control, are crucial to address the significant burden of BBD and improve overall health outcomes for children with T1D and their families.
泌尿系统并发症，包括尿失禁和尿路感染，在成年1型糖尿病（T1D）患者中很常见；然而，关于儿童T1D患者肠道和膀胱功能障碍（BBD）的患病率、相关危险因素及影响的数据仍然匮乏。本研究旨在调查与健康儿童对照组相比，T1D患儿中BBD的患病率，并探索与儿童BBD相关的临床因素。这项横断面、非干预性、多中心调查研究涉及北美5至16岁的T1D患儿和健康对照。参与者及其照料者完成了温哥华症状评分（VSS）以评估肠道和膀胱症状。BBD定义为VSS总分≥11分。采用逻辑回归来确定与BBD及症状困扰相关的潜在因素。在一组242名T1D参与者和86名对照中，46%为男性，中位年龄为11.0岁。发现T1D参与者中BBD的患病率更高，为21.5%，而对照组为10.5%。虽然在患有BBD的T1D组中刺激性症状最为常见，但尿失禁造成的困扰最大。在T1D组中，血糖控制较差与BBD的可能性更大有关，而男性及更严重的症状（如尿失禁）与这些症状带来的更大困扰相关。与健康对照相比，T1D患儿中BBD的患病率很高。这些数据凸显了对T1D患儿的BBD进行早期识别和干预的必要性。积极措施，如常规筛查和严格关注血糖控制的全面T1D管理，对于解决BBD的重大负担以及改善T1D患儿及其家庭的整体健康结局至关重要。
