儿童糖尿病控制效果及影响因素研究

Study on Effect of Diabetes Control and Influencing Factors in Children

目的本研究旨在评估健康保险、家庭构成形式、胰岛素管理方式等因素的关系,并探究其对1型糖尿病儿童血糖控制的影响。方法采用回顾性研究,对在浙江省两家三级甲等医院内分泌科就诊的儿童糖尿病患者进行调查。结果有私人商业保险患儿的血糖控制水平明显优于社会保险患儿(p<0.05)。来自双亲家庭患儿的血糖控制水平明显优于单亲家庭患儿(p<0.05)。采用胰岛素泵治疗的患儿血糖控制水平明显优于常规治疗、强化治疗患儿(p<0.05)。私人商业保险、双亲家庭、胰岛素泵治疗均有利于提高1型糖尿病儿童糖化血红蛋白达标率,是血糖控制水平良好的保护因素(p<0.05)。结论保险类型和家庭构成形式影响1型糖尿病患儿的血糖控制和胰岛素管理。未来识别和探究相关的影响因素,如家庭教育、家庭成员支持和监督等,有利于改善高风险糖尿病患儿的血糖控制水平。

Objective To evaluate the relationship among health insurance,family composition,insulin management and other factors and to explore the impact of such factors on glycemic control in children with type 1 diabetes.Methods A retrospective analysis was conducted to investigate pediatric patients with diabetes from the endocrinology department of two level-A tertiary hospitals in Zhejiang province.Results Children with private commercial insurance had significantly better glycemic control than those with social insurance(p<0.05).Children from two-parent families had significantly better glycemic control than those from single-parent families(p<0.05).Children using insulin pumps had significantly better glycemic control than those receiving routine treatments and intensive treatments(p<0.05).Private commercial insurance,two-parent families and treatments with insulin pumps could help improve the rate of glycated hemoglobin reaching the standard level in children with type 1 diabetes.These were protective factors for glycemic control(p<0.05).Conclusion Insurance type and family composition can influence glycemic control and insulin management in children with type 1 diabetes.Identifying and exploring relevant influencing factors,such as family education,and family member support and supervision,can help improve blood glucose control in children with high-risk diabetes.