1型糖尿病儿童生长发育及健康管理

Health management and growth development of type 1 diabetes mellitus children

目的研究1型糖尿病儿童生长发育及健康管理调查,为1型糖尿病患儿治疗提供指导。方法研究对象选取2018年6月至2021年6月在海南医学院第一附属医院内分泌科诊治的1型糖尿病患儿86病历资料,其中男41例,女45例,起病年龄为6~9岁,对所有其进行电话随访;记录并分析其自起病至成年的身高、体重、青春启动年龄、女性患儿的初潮年龄、血糖控制情况及并发症情况;结果患儿在起病初身高均较同龄儿低(P<0.05),达到终身高时患儿身高与同龄儿童无差异(P>0.05);男孩青春启动的中位年龄(12.10±1.50)岁较一般人群延迟(P<0.05),女孩青春启动的中位年龄(11.20±1.40)岁和初潮的中位年龄(14.90±2.10)岁均较一般人群推迟(P<0.05);11.63%(10/86)的患儿HbAl-c<7.0%,30.23%(26/86)患儿HbAl-c为7.0%~8.0%,58.14%(50/86)的患儿HbAl-c>8.0%;在青少年中糖尿病并发症虽不多见,但有1例(1.16%)视网膜病变,4例(4.65%)微量白蛋白尿;84例(97.67%)患儿进行血糖或尿糖监测,只有2例不监测。结论1型糖尿病儿童由于自控能力较差,又处于生长发育期,其血糖控制往往不理想,并发症虽不多见,但大多数血糖控制不理想,检测血糖不够,需加强糖尿病宣传教育,定期监测血糖。

Objective To investigate the growth,development and health management of children with type 1 diabetes,and to provide guidance for the treatment of children with type 1 diabetes.Methods From June 2018 to June 2021,86 children with type 1 diabetes diagnosed and treated in the Department of Endocrinology of our hospital from January 2000 to December 2002 were selected,including 41 males and 45 females,the onset age of 6-9 years old,all of whom were followed up by telephone.Height,weight,age of onset of youth,age of menarche,blood glucose control and complications were recorded and analyzed from onset to adulthood.Results The initial height of children were lower than those of children of the same age(P<0.05),and there was no difference in height between children of the same age and children of the same age when they reached lifetime height(P>0.05).The median age of initiation of puberty in boys was(12.10±1.50)years later than that in the general population(P<0.05),and the median age of initiation of puberty and menarche in girls were(11.20±1.40)years and(14.90±2.10)years later than that in the general population(P<0.05).11.63%(10/86)of children HbAl-c<7.0%,30.23%(26/86)in children with HbAl-c is 7.00%-8.00%,58.14%(50/86)in children with HbAl-c>8.0%.There were 1(1.16%)cases of retinopathy and 4(4.65%)cases of microalbuminuria.84 cases(97.67%)were monitored for blood glucose or urine glucose,and only 2 cases were not monitored.Conclusion Due to poor self-control and growth,the blood glucose control of children with type 1 diabetes is often not ideal.Although complications are rare,most blood glucose control is not ideal and blood glucose detection is not enough.Therefore,It is necessary to strengthen the publicity and education of diabetes and regularly monitor blood glucose.