Demographic and clinical characteristics of patients with type 1 diabetes mellitus: A multicenter registry study in Guangdong, China

Background A lack of demographic and clinical data hinders efforts of health care providers in China to support patients with type 1 diabetes mellitus (T1D). Therefore, the aim of the present retrospective study was to provide an overview of the demographic and clinical characteristics of Chinese patients with T1D. Methods Hospital medical records of patients with T1D (diagnosed between January 2000 and December 2011) in 105 secondary and tertiary hospitals across Guangdong province were reviewed. Data were collected on patient age at diagnosis, presentations at onset, physical examination, and diabetes management. Results In all, 3173 patients diagnosed with T1D between January 2000 and December 2011 were included in the study (46.2% female). The median age at diagnosis was 27.5 years (interquartile range [IQR] 18.0–38.0) years and the median body mass index (BMI) at onset was 19.6 kg/m2 (IQR 17.4–21.8 kg/m2). Among adult patients, 0.9% were obese, 6.6% were overweight, 62.3% were normal weight, and 30.3 % were underweight. The prevalence of diabetic ketoacidosis (DKA) at onset was 50.1%. The proportion of patients with retinopathy, nephropathy, and neuropathy was 8.1%, 20.7 %, and 11.1%, respectively. Conclusion The adult‐onset form of T1D is not rare in China. The registry participants were characterized by older age at onset, lower BMI, and a higher prevalence of DKA at onset compared with those in regions with a high incidence of T1D, such as northern Europe. These findings contribute to a better understanding of the heterogeneity of T1D in different populations and so will help healthcare providers to develop management models that are more suitable for these patients. 摘要 背景: 中国1型糖尿病患者的人口学及临床特征数据的缺乏妨碍了医疗保健工作者为1型糖尿病患者提供更好的支持。因此,此项回顾性研究旨在提供中国1型糖尿病患者人口学及临床特征的概况。 方法: 回顾广东省内105家二级及三级医院就诊的1型糖尿病患者的医院病历(2000年1月至2011年12月之间诊断)。收集患者的诊断时年龄、起病时表现、体格检查和糖尿病管理的相关数据。 结果: 本研究共纳入3173例在2000年1月至2011年12月间诊断的1型糖尿病患者(46.2%为女性)。他们的诊断年龄中位数为27.5岁(四分位间距[interquartile range, IQR],18.0‐38.0岁),起病时体重指数(body mass index,BMI)的中位数为19.6 kg/m2(IQR:17.4‐21.8 kg/m2)。在成年患者中,0.9%为肥胖,6.6%为超重,62.3%为正常体重,30.3%为低体重。起病时糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)的患病率为50.1%。患视网膜病变、肾脏病变和神经病变的患者分别为8.1%,20.7 %及11.1%。 结论: 成年起病的1型糖尿病患者在中国并不罕见。本研究注册的患者群体与高发病率地区(如北欧))的1型糖尿病患者相比,起病年龄更晚,BMI更低,起病时DKA的患病率更高。这些发现让我们对于1型糖尿病在不同人群的异质性有了更多了解,也帮助医疗保健工作者更好地制定适合这些患者的管理方式。 Distribution of age of onset of type 1 diabetes.