Comparison of anterior-posterior decade of glycemic control in type 1 diabetic children and adolescents

doi:10.3969/j.issn.1006-7795.2013.04.023

Abstract

Abstract:

Objective To compare of anterior-posterior decade glycemic control with improvement of diabetes management and evaluate influence of socioeconomic factors on glycemic control. Methods This cross-sectional clinical-based survey enrolled 158 T1DM children on December 2011 to May 2012(Group A) in Beijing children's hospital of more than one year management and compared with 123 T1DM children who were recruited in Asia and the West Pacific Region T1DM Study on December 2001 to May 2002(Group B) in Beijing children's hospital. Normally distributed data are reported as mean±SD, skewed data as median±interquartile range. Linear correlation and regression analysis were performed for glycemic control. Results There is no complication in both two groups. The average of HbA1C was 8.3±1.53%, better than ten years before 9.9±1.85 %(P=0.000). The ratio of optimal and suboptimal HbA1C of boys in group A and B were 16.4%, 68.5% vs 2.4%, 58.9%, P=0.000 respectively. The ratio of insulin injection twice daily and the frequency of SMBG in group A and B both girls and boys are statistically significant difference P=0.000 respectively. HbA1C was positive correlation with age, duration, insulin dosage per day and diabetic care costs by family while inverse correlation with frequency of SMBG in liner correlation and regression analysis. It was showed that duration was the most important factor. Socioeconomic survey showed that household income and parents' knowledge and educational levels did not affect glycemic control significantly in statistic. But there is a higher percentage of parents' knowledge and educational levels in optional subgroup than in the other two subgroups. About half of diabetic children whose household income were lower than the average level and their diabetic care costs were over 1/3 household income. Conclusion There were younger and more girls of type 1 dibetic children in Beijing children's hospital. The frequency of SMBG and the ratio of MDI and CSII were increasing significantly ten years after. Duration was the most important factor of glycemic control. There was no complication in children. Glycemic control would be better due to improvement SMBG and increasing the frequency of insulin injection. Socioeconomic survey showed that some diabetes household income were lower than the average level and diabetic care costs increased family burden.

Key words: type 1 diabetes mellitus, glycemic control, self-monitoring blood glucose(SMBG), insulin injection

CLC Number:

R587.1

WU Di, GONG Chunxiu, MENG Xi, WEI Liya, QIN Miao, HUANG Shuyue, LI Yuchuan. Comparison of anterior-posterior decade of glycemic control in type 1 diabetic children and adolescents[J]. Journal of Capital Medical University, 2013, 34(4): 596-600.

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https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2013/V34/I4/596

References

[1] Guariguata L. By the numbers: new estimates from the IDF diabetes atlas update for 2012[J]. Diabetes Res Clin Pract, 2012,98(3):524-525.

[2] Petitti D B, Kingersmith G J, Bell R A, et al. Glycemic control in youth with diabetes: The search for diabetes in youth study[J]. J Pediatr, 2009,155(5):668-672.

[3] Beaufort C E, Lange K, Swift P G F, et al. Metabolic outcomes in young children with type 1 diabetes differ between treatment centers: the Hvidoere Study in young children 2009[J]. Pediatric Diabetes, 2012 Sep 10. doi: 10.1111/j.1399-5448.2012.00922.x.[Epub ahead of print].

[4] DCCT Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus[J]. N Engl J Med, 1993,329(14):977-986.

[5] Chuang L M, Tsai S T, Huang B Y, et al. The status of diabetes control in Asia A cross-sectional survey of 24317 patients with diabetes mellitus in 1998[J]. Diabet Med, 2002,19(12):978-985.

[6] Craig M E, Handelsman P, Donaghue K C, et al. Predictors of glycaemic control and hypoglycaemia in children and adolescents with type 1 diabetes from NSW and the ACT[J]. Med J Aust, 2002,177(5):235-238.

[7] Cardwell C R, Patterson C C, Allen M, et al. Diabetes care provision and glycaemic control in Northern Ireland: A UK regional audit[J]. Archives of Disease in Childhood, 2005,90(5):468-473.

[8] Danne T, Mortensen H B, Hougaard P, et al. Persistent differences among centres over 3years in glycaemic control and hypoglycemia in a study of 3805 children and adolescents with type 1 diabetes from the Hvidore Study Group[J]. Diabetes Care, 2001,24(8):1342-1347.

[9] Mortensen H B, Hougaard P. Comparison of metabolic control in a cross-sectional study of 2873 children and aldolescents with IDDM from 18 countries. The Hvidore Study Group on Childhood Diabetes[J]. Diabetes Care, 1997,20(5):714-720.

[10] Scottish Study Group for the Care of the Young Diabetic. Factors influencing glycaemic control in young people with type 1 diabetes in Scotland: A population-based study(DIABAUD2)[J]. Diabetes Care, 2001,24(2):239-244.

[11] Rewers M, Pihoker C, Donaghue K, et al. Assessment and monitoring of glycemic control in children and adolescents with diabetes[J]. Pediatr Diabetes, 2009,10(Suppl 12):71-81.

[12] 巩纯秀,倪桂臣,刘敏等.18岁以下1型糖尿病病人管理状况的评估[J].中国糖尿病杂志,2003,11(3):172-175.

[13] Craig M E, Jones T W, Silink M, et al. Diabetes care, glycemic control,and complications in children with type 1 diabetes from Asia and the Western Pacific Region[J]. J Diabetes and Its Complications, 2007,21(5):280-287.

[14] Rosilio M, Cotton J B, Wieliczko M C, et al. Factors associated with glycaemic control. A cross-sectional nationwide study in 2579 French children with type 1 diabetes. The French Pediatric Diabetes Group[J]. Diabetes Care, 1998,21(7):1146-1153.

[15] Nathan D M, Zinman B, Cleary P A, et al. Mondern-day clinical course of type 1 diabetes mellitus after 30 years' duration: The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications and Pittsburgh Epidemiology of Diabetes Complications Experience(1983-2005)[J]. Arch Intern Med, 2009,169(14):1307-1316.

[16] Miller K M, Beck R, Bergenstal R, et al. Evidence of a strong association between frequency of self-monitoring of blood glucose and hemoglobin A1C levels in T1Dexchange clinic registry participants[J]. Diabetes Care, 2013,36(7):2009-2014.

[17] Rausch J, Hood K K, Delamater A, et al. Changes in treatment adherence and glycemic control during the transition to adolescence in type 1 diabetes[J]. Diabetes Care, 2012,35(6):1219-1224.

[18] Gomes M B, Mattos Mateus A S, Calliari L E, et al. Economic status and clinical care in young type 1 diabetes patients: a nationwide multicenter study in Brazil[J]. Acta Diabetol, 2012,Jun12.[Epub ahead of print](Published online).

[19] Jeff Unger. Comparing the efficacy, safety and utility of intensive insulin algorithms for a primary care practice[J]. Diabetes Ther, 2011,2(1):40-45.