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中国儿童1型糖尿病标准化诊断与治疗专家共识(2020版)
中华医学会儿科学分会内分泌遗传代谢学组
中华儿科杂志编辑委员会
作者及单位信息
·
DOI: 10.3760/cma.j.cn112140-20200221-00124
Expert consensus on the standardized diagnosis and management of type 1 diabetes mellitus in Chinese children (2020)
The Subspecialty Group of Endocrinologic, Hereditary and Metabolic Diseases, the Society of Pediatrics, Chinese Medical Association
the Editorial Board, Chinese Journal of Pediatrics
Luo Feihong
Luo Xiaoping
Authors Info & Affiliations
The Subspecialty Group of Endocrinologic, Hereditary and Metabolic Diseases, the Society of Pediatrics, Chinese Medical Association
the Editorial Board, Chinese Journal of Pediatrics
Luo Feihong
Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children′s Hospital of Fudan University, National Center for Children′s Health of China (Shanghai) , Shanghai 201102,China
Luo Xiaoping
Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
·
DOI: 10.3760/cma.j.cn112140-20200221-00124
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摘要

1型糖尿病(T1DM)是危害儿童健康的重大儿科内分泌疾病,我国儿童T1DM发病率快速增加且低龄化趋势明显。T1DM发病越早,慢性并发症导致的死亡风险就越大,患儿平均预期寿命减少约12年。我国儿童T1DM血糖控制达标率远低于西方国家,亟待系统化、规范化诊疗知识的普及。为进一步规范中国儿童T1DM的分型诊断、胰岛素治疗、血糖监测、急慢性并发症以及合并症的评估及治疗,由中华医学会儿科学分会内分泌遗传代谢学组联合中华儿科杂志编辑委员会专家讨论,并参考国内外的最新研究进展和共识指南,结合我国儿童T1DM的流行现状、临床研究成果,特制订本共识。

引用本文

中华医学会儿科学分会内分泌遗传代谢学组,中华儿科杂志编辑委员会. 中国儿童1型糖尿病标准化诊断与治疗专家共识(2020版)[J]. 中华儿科杂志,2020,58(06):447-454.

DOI:10.3760/cma.j.cn112140-20200221-00124

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1型糖尿病(type 1 diabetes mellitus, T1DM)约占儿童期各型糖尿病总数的90%,是危害儿童健康的重大儿科内分泌疾病,我国近年发病率为2/10万~5/10万,<5岁儿童发病率年平均增速5%~34% [ 1 , 2 ],提示发病呈现低龄化趋势。我国儿童期T1DM长期血糖控制、预后的流行病学现况资料缺乏,仅有的2006年多中心研究提示患儿平均糖化血红蛋白(glycohemoglobin A1c,HbA1c)为9.5%,中国单中心HbA1c达标率仅为15%,远低于美国和德国等欧洲国家的44%~59% [ 3 , 4 ]。儿童期T1DM发病越早,慢性并发症导致的死亡风险就越大,即使在西方发达国家,T1DM患儿的平均预期寿命减少12年 [ 5 , 6 ]。近2年来儿童2型糖尿病(type 2 diabetes mellitus,T2DM)、单基因糖尿病、T1DM营养管理共识相继发布,但儿童胰岛素使用指南、糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)治疗共识发布已10余年,尚缺乏涉及儿童糖尿病慢性并发症认识、筛查管理的规范,糖尿病分型、胰岛素治疗方法、血糖监测、DKA处理等涉及T1DM系统化、规范化管理的技术已有较多新的发展,为进一步提高我国儿童青少年T1DM临床诊疗的规范化水平,减少或延缓急、慢性并发症的发生,中华医学会儿科学分会内分泌遗传代谢学组联合中华儿科杂志编辑委员会特制定本共识。
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备注信息
A
罗飞宏,国家儿童医学中心(上海)复旦大学附属儿科医院内分泌遗传代谢科 201102,Email: nc.defudabe.nadufhfoul
B
罗小平,华中科技大学同济医学院附属同济医院儿科学系,武汉 430030,Email: nc.defudabe.umjt.hjtoulpx
C
所有作者均声明不存在利益冲突
D
国家重点研发计划重大慢性非传染性疾病防控研究 (2016YFC1305302、2016YFC1305301、2016YFC1305304)
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