期刊
JOURNAL OF PEDIATRICS
卷 155, 期 2, 页码 183-189出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2009.01.063
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资金
- NCRR NIH HHS [M01RR001271, M01 RR08084, M01RR00037, M01 RR01070, M01 RR00069] Funding Source: Medline
- NCCDPHP CDC HHS [U01 DP000247, U01 DP000246, U01 DP000245, U01 DP000244, U01 DP000248, U01 DP000254, U01 DP000250] Funding Source: Medline
Objectives To describe the insulin regimens used to treat type 1 diabetes mellitus (T1DM) in youth in the United States, to explore factors related to insulin regimen, and to describe the associations between insulin regimen and clinical outcomes, particularly glycemic control. Study design A total of 2743 subjects participated in the SEARCH for Diabetes in Youth study, an observational population-based study of youth diagnosed with T1DM, conducted at 6 centers. Data collected during a study visit included clinical and sociodemographic information, body mass index, laboratory measures, and insulin regimen. Results Sociodemographic characteristics were associated with insulin regimen. Insulin pump therapy was more frequently used by older youth, females, non-Hispanic whites, and families with higher income and education (P = .02 for females, P < .001 for others). Insulin pump use was associated with the lowest hemoglobin A1C levels in all age groups. A1C levels were >7.5% in >70% of adolescents, regardless of regimen. Conclusions Youth using insulin pumps had the lowest A1C; A1C was unacceptably high in adolescents. There is a need to more fully assess and understand factors associated with insulin regimens recommended by providers and the influence of race/ethnicity, education, and socioeconomic status on these treatment recommendations and to develop more effective treatment strategies, particularly for adolescents. (J Pediatr 2009; 155:183-9).
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