早期使用连续血糖监测可消除毛利族 1 型糖尿病儿童血糖指标的明显不平等。

Emergent inequity of glycaemic metrics for Māori children with type 1 diabetes is negated by early use of continuous glucose monitoring.

机构信息

Paediatric Department, University of Otago, Christchurch, Terrace House, 4 Oxford Terrace, Christchurch, New Zealand.

Biostatistics and Computation Biology Unit, University of Otago, Christchurch, New Zealand.

出版信息

N Z Med J. 2024 Jul 5;137(1598):14-21. doi: 10.26635/6965.6470.

DOI:10.26635/6965.6470

PMID:38963927

Abstract

AIM

We investigated if continuous glucose monitoring (CGM) in children with type 1 diabetes (T1D) within 12 months of being diagnosed modifies the development of glycaemic outcome inequity on the basis of either ethnicity or socio-economic status (SES).

METHOD

De-identified clinical and SES data from the KIWIDIAB data network were collected 12 months after diagnosis in children under 15 years diagnosed with T1D between 1 October 2020 and 1 October 2021.

RESULTS

There were 206 children with new onset T1D: CGM use was 56.7% for Māori and 77.2% for Europeans. Mean (SD) HbA1c was 62.4 (14.2) mmol/mol at 12 months post diagnosis, but Māori were 9.4mmol/mol higher compared to Europeans (p<0.001). For those without CGM, Māori had an HbA1c 10.8 (95% CI 2.3 to 19.4, p=0.013) mmol/mol higher than Europeans, whereas there was no evidence of a difference between Māori and Europeans using CGM (62.1 [9.3] mmol/mol vs 58.5 [12.4] mmol/mol p=0.53 respectively). Comparing quintiles of SES, HbA1c was 10.8 (95% CI 4.7 to 16.9, p<0.001) mmol/mol higher in the lowest quintile of SES compared to the highest.

CONCLUSION

These observational data suggest CGM use ameliorates the ethnic disparity in HbA1c at 12 months in new onset T1D.

摘要

目的

我们研究了在诊断后 12 个月内，15 岁以下新诊断为 1 型糖尿病（T1D）的儿童中，连续血糖监测（CGM）是否会根据种族或社会经济地位（SES）改变血糖结果的不公平性。

方法

从 KIWIDIAB 数据网络中收集了 2020 年 10 月 1 日至 2021 年 10 月 1 日期间新诊断为 T1D 的儿童的临床和 SES 数据，并在诊断后 12 个月时进行了去识别处理。

结果

共有 206 名新诊断的 T1D 儿童：CGM 使用率为毛利人 56.7%，欧洲人 77.2%。诊断后 12 个月时，平均（SD）HbA1c 为 62.4（14.2）mmol/mol，但毛利人比欧洲人高 9.4mmol/mol（p<0.001）。对于没有 CGM 的儿童，毛利人 HbA1c 比欧洲人高 10.8（95%CI 2.3 至 19.4，p=0.013）mmol/mol，而使用 CGM 的毛利人和欧洲人之间没有差异（62.1[9.3]mmol/mol 比 58.5[12.4]mmol/mol，p=0.53）。按 SES 五分位数进行比较，最低 SES 五分位数的 HbA1c 比最高 SES 五分位数高 10.8（95%CI 4.7 至 16.9，p<0.001）mmol/mol。