儿童和青少年1型糖尿病的临床和实验室特征:来自医疗中心的经验

W. Ting, Chi‐Yu Huang, F. Lo, Chen-Mei Hung, Chia-Jung Chan, Hsin-Jung Li, Chao-Hsu Lin, Hung-Chang Lee, Yann-Jinn Lee
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引用次数: 16

摘要

背景1型糖尿病(T1D)的发病率在全球范围内迅速增加,主要发生在年轻人中。我们为文献中报道的所有T1D症状制定了一份检查表,并比较了采用检查表前后首次出现时症状记录的完整性。方法回顾性分析1979年1月1日至2006年9月30日新诊断的T1D患者的临床资料,评估其表现特征,并检验症状检查表在评估发病史中的实用性。自1994年10月1日起,该清单已纳入记录。结果在304例患者中,130例(43%)患者有检查表。146例(48%)男孩,98例(32%)诊断为6岁以下,198例(65%)为糖尿病酮症酸中毒(DKA)。有检查表的记录比没有检查表的记录更容易注意到糖尿病症状的细微和容易被忽视。与年龄较大的患者相比,在<或= 6岁时诊断的患者更有可能是男性,患有DKA,症状持续时间较短,并且报告先前病毒感染和呼吸困难的发作较多。DKA患者的症状持续时间也较短。结论糖尿病症状检查表有助于识别易被忽视的糖尿病临床症状和体征。年龄较小的儿童更可能有较短的症状持续时间和较高的DKA发生率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical and laboratory characteristics of type 1 diabetes in children and adolescents: experience from a medical center.
BACKGROUND The incidence of type 1 diabetes (T1D) is increasing rapidly worldwide, predominantly in younger individuals. We developed a checklist of all symptoms of T1D reported in the literature and compared the completeness of the recording of symptoms at initial presentation before and after the checklist was adopted. METHODS We retrospectively reviewed the records of patients newly diagnosed with T1D from January 1, 1979 through September 30, 2006 to assess the presenting features and test the usefulness of a symptom checklist in evaluating the history on presentation. The checklist was incorporated into the records as of October 1, 1994. RESULTS Of the 304 patients identified, 130 (43%) had checklists in the charts. There were 146 (48%) boys, 98 (32%) who were diagnosed under the age of 6 years, and 198 (65%) presented with diabetic ketoacidosis (DKA). Records with a checklist noted diabetic symptoms that were subtle and easily ignored more often than records without the checklist. As compared with those diagnosed at an older age, patients diagnosed at < or = 6 years were more likely to be male, have DKA and a shorter symptom duration, and report more episodes of preceding viral infection and dyspnea. Patients with DKA also had a shorter symptom duration. CONCLUSIONS A diabetic symptom checklist was helpful in identifying clinical diabetic symptoms and signs which were otherwise easily ignored. Younger children were more likely to have a shorter symptom duration and a higher incidence of DKA.
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