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1型糖尿病儿童急性并发症的预测因素
Arleta Rewers1, H Peter Chase, Todd Mackenzie
1Pediatric Emergency Medicine, Department of Pediatrics, University of Colorado, School of Medicine, The Children's Hospital, Denver, CO 80218, USA. rewers.arleta@tchden.org
JAMA
|May 22, 2002
概括
糖尿病酸和严重的低血糖是1型糖尿病儿童的重大风险. 诸如低保险和精神疾病等可变因素增加了这些风险,凸显了针对性干预的必要性.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 代谢障碍 代谢障碍 代谢障碍
- 糖尿病管理 糖尿病管理
背景情况:
- 糖尿病酸和严重的低血糖是1型糖尿病的关键急性并发症.
- 这些情况是因胰岛素治疗失衡而产生的,但其他可修改的风险因素尚不清楚.
研究的目的:
- 为了确定患有糖尿病的儿童中酸性和严重低血糖的发生率.
- 确定儿童群体中这些严重糖尿病并发症的预测因素.
主要方法:
- 对1243名患有1型糖尿病的儿童 (婴儿至19岁) 进行前性队列研究.
- 在丹佛大都市区进行了3994个人年 (1996年1月至2000年12月) 的随访.
- 对酸和严重低血糖的发生率的分析,包括住院和急诊.
主要成果:
- 酸性脂肪酸症的发病率为每100人/年,8人/年,在女孩中随着年龄的增长而增加. 危险因素包括血红蛋白A1c (HbA1c) 高,胰岛素剂量高,保险不足和精神疾病.
- 严重低血糖的发病率为19/100人年,在女孩中随着年龄的增长而下降. 风险因素包括糖尿病持续时间较长,保险不足,HbA1c较低和精神疾病.
- 在20%的儿童中,复发事件占80%的发作.
结论:
- 一些患有1型糖尿病的儿童面临着持续的酸性和严重低血糖症的高风险.
- 特定于年龄和性别的模式突显了青少年女孩的酸性疾病挑战和年幼儿童和男孩的低血糖症.
- 有针对性的干预措施应集中在缺乏保险的儿童,患有精神疾病的儿童和极端HbA1c水平的儿童身上.
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