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目的 了解和评估北京地区儿童青少年 1型糖尿病病人的控制和管理情况。 方法 北京儿童医院进行管理的 18岁以下的病程 1年以上 1型糖尿病病人 12 3例。采用国际糖尿病联盟儿童青少年糖尿病协会统一问卷和标准采血测量HbA1 c。 结果 该组 1型糖尿病病人控制状况并不满意 ,平均HbA1 c为 9.8%,在亚太地区排为中下水平 ,管理方法需要改进。病程长短不是糖尿病控制好坏的决定因素 ;学龄前发病的病人易于管理 ,青春期较差 ;女性较难控制。血糖自我检测次数少 ,每月约 2次 ;胰岛素注射次数 92 %以上为每日注射 2次 ,明显少于西太地区 (WPR)平均水平。胰岛素用量不足 ( 0 .77± 0 2 5U·kg- 1 ·d- 1 ) ,与控制水平呈正相关。 结论 血糖自我检测少 ,胰岛素用量不足是糖尿病控制不良的主要因素。增加血糖自我监测次数和及时、足量的胰岛素治疗是改善糖尿病控制的主要方面。学龄前发病的病人依从性好 ,糖尿病得到了满意的控制 ,说明对糖尿病病人的管理比疾病本身对胰岛素的依赖更重要。
Objective To understand and evaluate the control and management of type 1 diabetes in children and adolescents in Beijing. Methods A total of 123 cases of type 1 diabetes mellitus with disease duration of 18 years and under were managed by Beijing Children’s Hospital over 1 year. Using the International Diabetes Federation Children and Adolescents Diabetes Association uniform questionnaire and standard blood sampling HbA1 c. Results The control group was not satisfied with the control of type 1 diabetes mellitus. The average HbA1c was 9.8%. It was ranked at the middle and lower level in the Asia Pacific region and the management method needs to be improved. The duration of the disease is not a determinant of good or bad diabetes control; pre-school patients are easy to manage, poor adolescence; and women are more difficult to control. Blood glucose self-test frequency less about 2 times per month; more than 92% of insulin injections were injected twice daily, significantly less than the average level of the Western Pacific (WPR). Inadequate use of insulin (0 .77 ± 0 2 5U · kg-1 · d-1), and the control level was positively correlated. Conclusion There are few self-tests of blood glucose and insufficient insulin dosage are the main factors of poor control of diabetes. Increasing the number of self-monitored blood glucose and timely and adequate insulin treatment are the main aspects of improving diabetes control. Pre-school patients with good compliance, diabetes has been satisfactorily controlled, indicating that the management of patients with diabetes than the disease itself depends on insulin is more important.