Clinical Incidence and Characteristics of Newly Diagnosed Type 1 Diabetes in Chinese Children and Adolescents: A Nationwide Registry Study of 34 Medical Centers

Frontiers in Pediatrics

article

Guo-Hua Li¹  Ke Huang¹  Guan-Ping Dong¹  Jian-Wei Zhang²  Chun-Xiu Gong³  Fei-Hong Luo⁴  Xiao-Ping Luo⁵  Chun-Lin Wang⁶  Min Zhu⁷  Pin Li⁸  Ling Wang⁹  Jun-Fen Fu¹ 

[1] The Children's Hospital of the Zhejiang University School of Medicine, National Clinical Research Center for Child Health;Department of Pediatrics, Shaoxing Maternal and Child Health Care Hospital;Endocrinology, Genetics, and Metabolism, Beijing Diabetes Center for Children and Adolescents, Medical Genetics Department, Beijing Children's Hospital;Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University;Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology;Department of Pediatric, The First Affiliated Hospital of Zhejiang University School of Medicine;Department of Endocrinology, Children's Hospital of Chongqing Medical University;Department of Endocrinology, Shanghai Children's Hospital of Shanghai Jiao Tong University;Laboratory for Translational Genetics, Department of Human Genetics

关键词: type 1 diabetes;    incidence;    diabetic ketoacidosis;    β-cell function;    children and adolescences;   

DOI  :  10.3389/fped.2022.888370

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective To investigate the clinical incidence and characteristics of type 1 diabetes mellitus (T1DM) of children and adolescents at the time of initial diagnosis in China. Methods Data on all pediatric patients with newly diagnosed T1DM were retrospectively collected from 34 medical centers in 25 major cities in China from January 2015 to January 2020. Patients were classified into three age groups: <5 years, 5 to <10 years, and ≥10 years of age. The same patient population was also categorized into diabetic ketoacidosis (DKA) and non-DKA groups based on clinical criteria. Results The mean annual clinical incidence of T1DM was 3.16/100,000 from the years 2015 to 2019. A total of 6,544 patients with newly diagnosed T1DM aged 0–16 years (median 7.84 ± 3.8) were studied [ages <5 years (29.3%), 5 to <10 years (38.7%), and ≥10 years (32%)], 52.4% of them were women. In total, 90.5% of the cases were occurred in individuals without a family history. Patients had lower C-peptide (CP) and body mass index (BMI) z scores when compared with healthy children, 41.8% of them had measurable T1DM-related antibodies and 52.7% had DKA. Among all three age groups, the <5 years group had the lowest BMI z score, CP, and glycated hemoglobin (HbA1c) on average, while it had the highest incidence rate of DKA (56.9%). Compared to the non-DKA group, the DKA group was significantly younger, with a lower BMI z score and CP, higher antibody positive rate, HbA1c, and the rate of insulin pump therapy. Conclusion The clinical incidence of T1DM in children and adolescents in China was 3.16/100,000. Patients with DKA at the first diagnosis of T1DM have a worse β-cell function. Public health measures for the prevention and treatment of T1DM should focus on preschoolers (aged <5 years) in particular, considering the severity and the highest frequency of DKA in this age group. More efforts should be dedicated to early screening and diagnosis of the T1DM.

【 授权许可】

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