Characteristics of adult- compared to childhood-onset type 1 diabetes
Characteristics of adult- compared to childhood-onset type 1 diabetes
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DOI：
10.1111/dme.14314
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发表时间：
2020-05-21
影响因子：
3.5
通讯作者：
Peters, A. L.
中科院分区：
文献类型：
--
作者：
Casu, A.;Kanapka, L. G.;Peters, A. L.
Aims To comparison diagnosis characteristics，diabetes management and comorbidities in a population diabetes involved with type 1 diabetes in childhood with those in a similar population diabetes onset.Methods This analysis was performed using the T1D Exchange Clinic Registry，a cross-sectional survivor cohort.回顾性收集的特征进行了比较，在以下年龄在诊断groups. ResultsThe整个队列包括20 660名参与者[51%的女性，中位数（四分位数范围）年龄18（14-36）岁，82%的非西班牙裔白色]。糖尿病酮症酸中毒在儿童期发病者中更常见。被诊断为成人的参与者在诊断时更有可能超重/肥胖，并且在1型糖尿病诊断之前使用口服药物（57%）。目前胰岛素泵的使用频率在年龄较大的参与者中较低。通过HbA（1c）、胰岛素需求和使用动态血糖监测仪测量的当前血糖控制在诊断时的年龄之间没有差异。腹腔疾病是唯一的合并症，观察到有不同的频率，在诊断的年龄，更常见的参与者诊断在一个年轻的age.Conclusions这些结果显示1型糖尿病诊断在儿童与成人之间的差异和相似性;值得注意的是，儿童糖尿病酮症酸中毒发病率较高，口服降糖药的使用率较高成人代理数据表明，在儿童期与成年期诊断的1型糖尿病的临床特征和结局之间几乎没有区别。在所有年龄组中，优化血糖控制仍然是一项挑战，胰岛素泵的使用率较低，影响了被诊断为成人的患者。
Aims To compare diagnosis characteristics, diabetes management and comorbidities in a population diagnosed with type 1 diabetes in childhood with those in a similar population diagnosed in adulthood to identify disease differences related to the age of diabetes onset.Methods This analysis was performed using the T1D Exchange Clinic Registry, a cross-sectional survivor cohort. Retrospectively collected characteristics were compared across the following age-at-diagnosis groups: = 40 years.Results The entire cohort included 20 660 participants [51% female, median (interquartile range) age 18 (14-36) years, 82% non-Hispanic white]. Diabetic ketoacidosis at diagnosis was more common among those with onset in childhood. Participants diagnosed as adults were more likely to be overweight/obese at diagnosis and to have used oral agents preceding type 1 diabetes diagnosis (57%). Current insulin pump use was less frequent in participants diagnosed at older ages. Current glycaemic control, measured by HbA(1c), insulin requirements and use of a continuous glucose monitor were not different by age at diagnosis. Coeliac disease was the only comorbidity that was observed to have a different frequency by age at diagnosis, being more common in the participants diagnosed at a younger age.Conclusions These results show differences and similarities between type 1 diabetes diagnosed in childhood vs adulthood; notably, there was a tendency for there was a higher frequency of diabetic ketoacidosis at onset in children and a higher frequency of use of oral antidiabetes agents in adults. The data indicate that there is little distinction between the clinical characteristics and outcomes of type 1 diabetes diagnosed in childhood vs adulthood. Optimizing glycaemic control remains a challenge in all age groups, with lower use of insulin pumps impacting those diagnosed as adults.