early markers of glycaemic control in children with type 1 diabetes mellitus早期的标记在儿童1型糖尿病血糖控制.pdfVIP

Early Markers of Glycaemic Control in Children with Type 1 Diabetes Mellitus 1 ´ 1 2 1,3 2 Samuel W. Cutfield , Jose G. B. Derraik , Peter W. Reed , Paul L. Hofman , Craig Jefferies , Wayne S. Cutfield1,3* 1 Liggins Institute, University of Auckland, Auckland, New Zealand, 2 Starship Children’s Hospital, Auckland District Health Board, Auckland, New Zealand, 3 National Research Centre for Growth and Development, University of Auckland, Auckland, New Zealand Abstract Background: Type 1 diabetes mellitus (T1DM) may lead to severe long-term health consequences. In a longitudinal study, we aimed to identify factors present at diagnosis and 6 months later that were associated with glycosylated haemoglobin (HbA1c) levels at 24 months after T1DM diagnosis, so that diabetic children at risk of poor glycaemic control may be identified. Methods: 229 children ,15 years of age diagnosed with T1DM in the Auckland region were studied. Data collected at diagnosis were: age, sex, weight, height, ethnicity, family living arrangement, socio-economic status (SES), T1DM antibody titre, venous pH and bicarbonate. At 6 and 24 months after diagnosis we collected data on weight, height, HbA1c level, and insulin dose. Results: Factors at diagnosis that were associated with higher HbA1c levels at 6 months: female sex (p,0.05), lower SES (p,0.01), non-European ethnicity (p,0.01) and younger age (p,0.05). At 24 months, higher HbA1c was associated with lower SES (p,0.001), Pacific Island ethnicity (p,0.001), not living with both biological parents (p,0.05), and greater BMI SDS (p,0.05). A regression equation to predict HbA1c at 24 months was consequently developed. Conclu