Clinical Characteristics And Follow-up Study Of 105 Children With T2DM

Objective: With the improvement of people’s living standard,the incidence of type 2diabetes in children,which used to be rare,has gradually increased,and there are few reports on the short-term treatment effect and long-term follow-up results of T2 DM in children in China.This study aims to investigate the clinical characteristics,short-term treatment effect and long-term follow-up results of T2 DM in children.Methods: In this study,a retrospective case-control study was used to collect clinical date of 105 children with T2 DM from 2018 to December 2019 in the Department of Endocrinology,Genetic Metabolism,Shengjing Hospital Affiliated to China Medical University,and the clinical characteristics were summarized and the changes of laboratory indicators were studied during regular visit and follow-up 3 months,6 to 18 months and24 to 36 months after diagnosis.The clinical data of the children at the time of diagnosis were taken as the case group,and the laboratory indicators after diagnosis were compared respectively,so as to clarify the changes of relevant indicators and the incidence of complications.Results: Among the 105 patients diagnosed with T2 DM,54 were male and 51 were female,74 had positive family history(70.48%),80 had non-alcoholic fatty liver(76.20%),87 had dyslipidemia(82.86%),and 10 had ketoacidosis(9.52%).Among them,children < 12 years old had higher fatty liver rate,higher alanine transaminase level and lower creatinine level than children 12 to 14 years old,and were more dependent on insulin treatment.3 months and 6 to 18 months after diagnosis,the glycosylated hemoglobin level in our hospital was improved compared with the diagnosis,the difference was statistically significant(P < 0.05).81 patients participated in follow-up and inter-clinic review 24 to 36 months after diagnosis.The HBA1 c was improved,and the BMI Z value was decreased,the difference was statistically significant(P < 0.05).Since the diagnosis,the level of glycosylated hemoglobin decreased and gradually increased,and the rates of kidney disease,retinopathy and electromyography abnormalities gradually increased.The occurrence of diabety-related complications was positively correlated with the contents of serum cholesterol and triglyceride.Conclusions: Children with type 2 diabetes<12 years old who were diagnosed for the first time had a shorter average course of disease,a higher positive rate of family history,and more dependent on insulin treatment to achieve blood glucose stability compared with older children.The level of glycosylated hemoglobin gradually increased at 3months,6～18 months and 24～36 months after the diagnosis of diabetes,and more of them had worse control(>10.0%).During follow-up,more patients needed to add or restart insulin for treatment.The increased incidence of complications in children with T2 DM may be positively correlated with elevated serum cholesterol and triglycerides.