Comparing long-term outcomes of children treated with new-onset type 2 diabetes in an outpatient versus inpatient setting: A retrospective chart review

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2024-05-16 DOI:10.1111/1753-0407.13571

Adesh Ranganna, Wenya Chen, Sean DeLacey, Juan Lado, Laura Levin, Anita Swamy, Monica E. Bianco

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Abstract

Background

Early identification and management of pediatric type 2 diabetes mellitus (T2DM) is crucial for improving long-term outcomes. This study aimed to assess if the severity of T2DM at presentation, inferred by the location of treatment initiation (inpatient or outpatient), influences long-term clinical outcomes.

Methods

A retrospective chart review was conducted on 116 pediatric T2DM patients. Data on treatment initiation location, initial and subsequent glycated hemoglobin (HbA1c) levels, prescribed insulin, and body mass index were collected from electronic medical records.

Results

Of the 116 patients, 69 were initially treated in an inpatient setting, and 47 received outpatient treatment. At treatment initiation, the inpatient group had significantly higher HbA1c levels compared to the outpatient group (p < .001), but 3 years after treatment initiation, no significant difference in HbA1c was observed between the two groups (p = .057). Prescribed insulin dosages were higher in the inpatient group at treatment initiation (p < .001) and remained higher after 3 years (p < 0.003) compared to the outpatient group.

Conclusions

Pediatric patients initially treated in an inpatient setting had poorer glycemic control and higher prescribed insulin dosing at baseline. After 3 years, there was no significant difference in HbA1c levels, but patients treated as inpatients continued to have higher prescribed insulin. These findings suggest that the severity of diabetes at initial presentation may affect long-term clinical outcomes in children with T2DM.

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比较门诊与住院治疗新发 2 型糖尿病儿童的长期疗效：回顾性病历

背景：早期识别和管理儿科2型糖尿病（T2DM）对改善长期预后至关重要。本研究旨在评估根据开始治疗的地点（住院或门诊）推断的发病时 T2DM 的严重程度是否会影响长期临床预后：方法：对 116 名儿科 T2DM 患者进行了回顾性病历审查。方法：对 116 名儿童 T2DM 患者进行了回顾性病历审查，从电子病历中收集了有关治疗开始地点、初始和后续糖化血红蛋白 (HbA1c) 水平、处方胰岛素和体重指数的数据：116 名患者中，69 人最初在住院治疗，47 人接受门诊治疗。开始治疗时，住院组患者的 HbA1c 水平明显高于门诊组患者（P最初接受住院治疗的儿科患者血糖控制较差，基线胰岛素剂量较高。3 年后，HbA1c 水平没有显著差异，但住院患者的胰岛素处方用量仍然较高。这些研究结果表明，初次发病时糖尿病的严重程度可能会影响 T2DM 患儿的长期临床治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.