Influence of disease course and comprehensive management on blood glucose level in children and adolescents with type 2 diabetes mellitus

• Published in: Journal of diabetes investigation Vol. 15; no. 8; pp. 1026 - 1033
• Main Authors: Wu, Xiaozhi, Wang, Rui, Chen, Jiahui, Feng, Guoshuang, Wang, Xinyu, Bai, Robin N, Liang, Xuejun, Cao, Bingyan, Gong, Chunxiu, Li, Wenjing, Sang, Yanmei, Wang, Xumei, Wu, Di
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.08.2024; John Wiley and Sons Inc; Wiley
• Subjects: Adolescent; Adolescents; Beta cells; Biomarkers - blood; Blood glucose; Blood Glucose - analysis; Blood levels; Body mass index; Child; Children; Children & youth; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - therapy; Diabetic neuropathy; Diet; Disease; Disease Management; Disease Progression; Disease resistance; Exercise; Female; Follow-Up Studies; Glucose; Glycated Hemoglobin - analysis; Glycemic Control; Hemoglobin; Homeostasis; Hospitals; Humans; Hypoglycemic Agents - therapeutic use; Insulin Resistance; Insulin-Secreting Cells - physiology; Lifestyles; Male; Medical diagnosis; Metabolism; Nutrition research; Obesity; Original; Overweight; Patients; Pediatrics; Peptides; Peripheral neuropathy; Physical fitness; Prognosis; R&D; Research & development; Teenagers; Type 2 diabetes mellitus; Beijing China; United States > US; China; Glycemic control; Type 2 diabetes mellitus; Children
• ISSN: 2040-1116; 2040-1124; 2040-1124
• DOI: 10.1111/jdi.14194

Aims/Introduction The aim of the present study was to evaluate the status of glycemic control, and assess the effects of the disease course and comprehensive management measures on the blood glucose level in children and adolescents with type 2 diabetes mellitus. Materials and Methods The study collected the clinical data of type 2 diabetes patients in Beijing Children's Hospital from January 2015 to September 2020. Patients were grouped based on the disease course to compare their glycated hemoglobin (HbA1c) level, islet β‐cell function, insulin resistance and comprehensive management measures. Results Of the 170 participants, the median disease course was 2.0 years (interquartile range [IQR] 1.0–4.0 years). The baseline HbA1c was 11.2% (IQR 9.2–12.4%). According to the grouping by the disease course, the median HbA1c was the lowest (5.7% [IQR 5.3–6.1%]) in the half‐year course group and the highest in the 4‐year course group (9.0 [IQR 6.8%–11.3%]). Compared with the group with a disease duration <2 years, patients in the >4 years group had a lower proportion of patients with HbA1c <7% (29.2% vs 66.2%), a lower homeostasis model assessment of β‐cell function, and a lower proportion with a controlled diet, moderate‐intensity exercise, regular follow up and no drug treatment. We deemed HbA1c as the dependent variable, and found that disease duration, homeostasis model assessment of β‐cell function at follow up, continuous moderate‐intensity exercise, regular review and treatment regimen were significant influencing factors for glycemic control. Conclusions Children and adolescents with type 2 diabetes and a prolonged disease course showed poor glycemic control and decreased islet β‐cell function. A good lifestyle, especially moderate‐intensity exercise, can help such cases better control their blood glucose level. So far, few studies on comprehensive type 2 diabetes management in children and adolescents in China have been analyzed, so we recruited 170 children with type 2 diabetes from Beijing Children's Hospital. The results of this study showed that with the prolongation of type 2 diabetes in children and adolescents, blood glucose control was poor and the function of islet β‐cells decreased. A good lifestyle, especially moderate exercise, can help children and adolescents better manage type 2 diabetes. Therefore, for children and adolescents with type 2 diabetes with long disease course should have strengthened diabetes education, increased compliance, and be encouraged and helped to follow a good lifestyle. In particular, these patients should be encouraged to exercise actively. Through integrated management, the quality of life of children and adolescents with diabetes can be improved.