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拉丁美洲儿童1型糖尿病困扰相关的临床和人口统计学特征

Clinical and Demographic Characteristics Associated with Type 1 Diabetes Distress in Latin American Children.

作者信息

Hirschler Valeria, Benitez Amanda, Marassi Andrea Escalante, Arrigo Angeles, Andres Eugenia, Codner Ethel, Rojas Godoy Juan Pablo, Molinari Claudia, Araujo Luciana, Porta Fabio Palacios, Witte Daniel R

机构信息

Epidemiology Division, Diabetes Argentine Society, Buenos Aires, Argentina.

Epidemiology Division, Hospital, Pediatrico Juan Pablo Segundo, Corrientes, Argentina.

出版信息

J Pediatr Clin Pract. 2025 Aug 8;17:200173. doi: 10.1016/j.jpedcp.2025.200173. eCollection 2025 Sep.

Abstract

OBJECTIVE

To determine the degree of diabetes-specific distress in children with type 1 diabetes mellitus (T1DM) and its association with demographic characteristics, family and educational situation indicators, glycemic control, complications, and disease duration.

STUDY DESIGN

A cross-sectional study (Jan-Mar 2025) in Argentina and Chile included 143 T1DM patients (8-17 years, ≥1-year duration). Diabetes distress was measured using the Problem Areas in Diabetes (PAID) questionnaire (0-80; high distress ≥40).

RESULTS

One hundred forty-three children (53.8%; 77 females), median age 13.4 years (IQR 11.5-15.8 years), T1DM duration 4.4 y (IQR 3.3-6.6 years), hemoglobin A1c (HbA1c) 8.5%, 69.8 mmol/mol (IQR 7.4%-9.4%), were included. The median PAID score was 25 (IQR 15-42), with 28% (95% CI: 20.6-35.3) experiencing high distress (PAID ≥ 40). HbA1c was higher in children with high distress 9.00% (IQR: 8.1%-10.4%) than in moderate 8.5% (IQR: 7.5%-9.7%) or low distress 7.8% (IQR: 7.0%-8.9%). There was a higher prevalence of children living with only one parent among those with high or moderate distress (33.3%, 95% CI: 24%-34%) compared to those with low distress (9.8%, 95% CI: 2%-18%). Multiple logistic regression analysis revealed that higher HbA1c values were significantly associated with being in the high distress group (OR = 1.48; 95% CI: 1.12-1.96 per % point HbA1c), adjusted for confounding variables.

CONCLUSIONS

Diabetes distress was linked to higher HbA1c in Latin American children with T1DM. This suggests that addressing diabetes distress may contribute to improved glycemic control.

摘要

目的

确定1型糖尿病(T1DM)患儿的糖尿病特异性困扰程度及其与人口统计学特征、家庭和教育状况指标、血糖控制、并发症及病程的关联。

研究设计

2025年1月至3月在阿根廷和智利开展的一项横断面研究纳入了143例T1DM患者(8至17岁,病程≥1年)。使用糖尿病问题领域(PAID)问卷(0至80分;高困扰≥40分)测量糖尿病困扰程度。

结果

纳入了143名儿童(53.8%;77名女性),中位年龄13.4岁(四分位间距11.5至15.8岁),T1DM病程4.4年(四分位间距3.3至6.6年),糖化血红蛋白(HbA1c)8.5%,69.8 mmol/mol(四分位间距7.4%至9.4%)。PAID评分中位数为25(四分位间距15至42),28%(95%置信区间:20.6至35.3)的儿童有高困扰(PAID≥40)。高困扰儿童的HbA1c水平较高,为9.00%(四分位间距:8.1%至10.4%),高于中度困扰儿童的8.5%(四分位间距:7.5%至9.7%)和低困扰儿童的7.8%(四分位间距:7.0%至8.9%)。高困扰或中度困扰儿童中单亲家庭儿童的患病率(33.3%,95%置信区间:24%至34%)高于低困扰儿童(9.8%,95%置信区间:2%至18%)。多因素逻辑回归分析显示,在对混杂变量进行校正后,较高的HbA1c值与高困扰组显著相关(比值比=1.48;每增加1%的HbA1c,95%置信区间:1.12至1.96)。

结论

拉丁美洲T1DM患儿的糖尿病困扰与较高的HbA1c水平相关。这表明解决糖尿病困扰可能有助于改善血糖控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ca6/12409447/f95415c140c0/gr1.jpg

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