Objective: To explore the factors associated with glycemic control in children and adolescents with type 1 diabetes mellitus (T1DM) treated with continuous subcutaneous insulin infusion (CSII). Methods: Subjects were enrolled from the Guangdong Type 1 Diabetes Translational Medicine Study between June 2011 and August 2017. Patients with T1DM aged less than 18 years and treated with CSII for at least 6 months were included. Demographic data and clinical information on self-monitoring of blood glucose (SMBG), glycosylated hemoglobin (HbA1c) and insulin treatment were collected. Participants were categorized based on HbA1c levels as sufficient control group (HbA1c<7.5% ) and insufficient control group ( HbA1c≥7.5%). A multivariate logistic regression model was used to examine the factors associated with glycemic control. Results: A total of 142 participants (76 females, 66 males) with a median age of 13.0 (9.9, 15.0) years and a median disease duration of 3.0 (1.6, 5.0) years were enrolled. HbA1c was (8.2±2.0)% and 41.55%(59/142) of patients achieved the target for HbA1c. The frequency of SMBG was 5.0 (2.0, 8.0) and 3.0 (1.0, 4.0) tests per day (P<0.001), and the frequency of hypoglycemia was 2.0 (0.8, 4.0) and 1.0 (0, 2.0) times per week (P=0.003) in sufficient control group and insufficient control group, respectively. Sufficient glycemic control (HbA1c <7.5%) was associated with the frequency of SMBG (OR=1.238, 95% CI: 1.088-1.409, P=0.001). Conclusion: A higher frequency of SMBG is one of the key factors to achieve sufficient glycemic control among children and adolescents with T1DM treated with CSII.
目的： 探讨持续皮下胰岛素输注治疗的青少年儿童1型糖尿病(T1DM)患者血糖特点及其达标相关因素。 方法： 研究对象来自2011年6月至2017年8月广东省1型糖尿病转化医学研究。纳入年龄<18岁，使用持续皮下胰岛素输注治疗6个月以上的T1DM患者。收集人口学特征、自我血糖监测频率(SMBG)以及胰岛素治疗情况等资料。根据糖化血红蛋白(HbA1c)分为达标组(HbA1c<7.5%)和未达标组(HbA1c≥7.5%)，多因素logistic回归模型分析血糖达标的相关因素。 结果： 共142例患者纳入分析(女76例，男66例)，年龄13.0(9.9，15.0)岁，病程3.0(1.6，5.0)年，HbA1c(8.2±2.0)%，达标率41.55%(59/142)。HbA1c达标组和未达标组SMBG分别为5.0(2.0，8.0)次/d和3.0(1.0，4.0)次/d(P<0.001)，低血糖发生频率分别为2.0(0.8，4.0)次/周和1.0(0，2.0)次/周(P＝0.003)。多因素logistic回归分析结果显示，校正了年龄、病程后，自我血糖监测频率高与血糖达标独立相关(OR＝1.238，95% CI：1.088～1.409，P＝0.001)。 结论： 对于持续皮下胰岛素输注治疗的青少年儿童1型糖尿病患者，较高频次的自我血糖监测是获得良好血糖控制的关键。.
Keywords: Adolescent; Child; Diabetes mellitus, type 1; Hemoglobin A, glycosylated; Insulin infusion systems.