1. A single center study on the current state of blood glucose control and related factors analysis in children with type 1 diabetes mellitus from 2015 to 2019.
- Author
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Qin Miao, Gong Chunxiu, Cao Bingyan, Wang Rui, Feng Guoshuang, Wu Di, Liang Xuejun, Li Wenjing, Liu Min, Su Chang, Chen Jiajia, Li Xiaoqiao, Meng Xi, Wei Liya, Wang Qiao, and Liu Ying
- Abstract
Objective To investigate the overall state of the glycemic control in children with type 1 diabetes mellitus (T1DM) in a single center and analyze the related factors. Methods This cross sectional clinical based research was conducted among patients under 18 years old diagnosed with type 1 diabetes (the duration of diabetes>3 months) from the Diabetes Clinic of Beijing Children's Hospital from January 2015 to December 2019. The patients were required to receive a follow up every 3 months. The follow up data of the same patient were collected once a year. Glycosylated hemoglobin (HbA
1c ) was taken as the main research index (the selection principle was the median glycosylated hemoglobin per year). Demographic data included age at onset and at follow up, sex, duration of diabetes, years of follow up. In addition, clinical information on weight, height, modalities of insulin treatment (number of injections or pump therapy), the frequency of self monitoring of blood glucose (SMBG) per day or using of continuous glucose monitoring (CGM)/flash glucose monitoring (FGM) were collected. According to the years of follow-up, the patients were divided into 5 groups. According to the HbA1c control target (7.0%), the patients were divided into the good-control group (HbA1c <7.0%) and the poor-control group (HbA1c ≥7.0%). According to the age of the patients, they were divided into three groups (<5 years old group, 5 to 10 years old group and>10 years old group). The general situation of blood glucose control from 2015 to 2019 was compared by groups, and the related factors were analyzed by linear regression and two level logistic regression. Results A total of 1 976 patients with T1DM were collected (2015 n=362, 2016 n=410, 2017 n=415, 2018 n=384, 2019 n=405), the age was 10.09 (7.18, 12.85) years old; the duration of diabetes was 1.94 (0.88, 3.86) years, 49.5% (978/1 976) were male. There was no significant difference in age, sex and duration of disease among each groups (P>0.05), and comparable. HbA1c decreased from 7.4% (6.7%, 8.3%) in 2015 to 6.8% (6.1%, 7.6%) in 2019 (P< 0.01). The rate of achieved A1C target increased year by year [34.5% (125/362), 42.0% (172/410), 47.0% (195/415), 55.2% (212/384) and 56.3% (228/405), respectively], and the difference was statistically significant (Z=7.02, P<0.01). The HbA1C was positively correlated with age and duration of disease (r=0.095, 0.170 respectively, P<0.01). Logistic regression analysis showed that older of age, longer duration of disease and less frequency of daily blood glucose monitoring were the risk factors of failing to achieve HbA1c target. Conclusions From 2015 to 2019, HbA1c in children with T1DM has decreased year by year, and the rate of achieved A1C target has increased year by year, and it has increased by 1.63 times in 2019 compared with 2015. The increase in the use of CGM/FGM is the main factor to improve blood glucose control. [ABSTRACT FROM AUTHOR]- Published
- 2021
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