中国儿童糖尿病诊治进展  

Progress in diagnosis and treatment of pediatric diabetes in China

作　　者：裴舟[1] 罗飞宏[1] PEI Zhou;LUO Feihong(Department of Pediatric Endocrinology and Inherited Metabolic Diseases,Children's Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]复旦大学附属儿科医院内分泌代谢科,上海201102

出　　处：《诊断学理论与实践》2024年第5期461-466,共6页Journal of Diagnostics Concepts & Practice

基　　金：癌症、心脑血管、呼吸和代谢性疾病防治研究国家科技重大专项“数智化1型糖尿病防控新体系建立”(2023ZD0509100)。

摘　　要：全球0~19岁儿童青少年的1型糖尿病(type 1 diabetes mellitus,T1DM)患病率约为1 211.9/1 000万,发病率为149.5/100万人年;中国0~19岁儿童青少年T1DM患病率约为56/100万,发病率为6.1/100万人年。儿童青少年2型糖尿病(type 2 diabetes mellitus,T2DM)的发病率也逐年上升。流行病学数据显示,美国青少年T2DM的患病率从2001年的34/10万增至2009年的46/10万和2017年的67/10万。我国儿童T2DM也呈明显上升趋势,儿童T2DM患病率由1995年的4.1/10万上升至2010年的10.0/10万。中国儿童糖尿病的诊断标准采用的是2019年世界卫生组织颁布的标准。与儿童相关的糖尿病亚型包括T1DM、T2DM、混合型糖尿病、其他特殊类型糖尿病。成人糖尿病的典型临床表现为多饮、多尿、多食和体重下降(三多一少),儿童T1DM患儿三多一少症状较明显,T2DM可较为隐匿。传统T1DM治疗主要采用胰岛素治疗,但无法从根本上解决胰岛功能减退的问题,阻止/延缓β细胞损伤,保护残存的胰岛功能,已成为T1DM治疗的新研究方向。除传统的胰岛素治疗和生活方式干预外,免疫治疗、人工胰腺和干细胞移植等新的治疗甚至治愈糖尿病的技术已初步展现出令人振奋的临床效果,不仅为糖尿病的未来治疗提供了新方向,也有可能使糖尿病从不治之症转变为可治之症。The global incidence of type 1 diabetes mellitus(T1DM) in children and adolescents aged 0-19 years is about 1 211.9/10 million,with an incidence rate of 149.5/1 million person-years.In China,the incidence of T1DM in children and adolescents aged 0-19 years is about 56/1 million,with an incidence rate of 6.1/1 million person-years.The incidence of type 2 diabetes mellitus(T2DM) in children and adolescents has been rising annually.Epidemiological data shows that the incidence of T2DM among adolescents in the United States increased from 34/100 000 in 2001 to 46/100 000 in 2009 and to 67/100 000 in 2017.In China,the incidence of pediatric T2DM has also shown a significant upward trend,rising from 4.1/100 000 in 1995 to 10.0/100 000 in 2010.The diagnostic criteria for pediatric diabetes in China follow the standards set by the World Health Organization in 2019.Diabetes subtypes related to children include T1DM,T2DM,mixed-type diabetes,and other specific types of diabetes.The typical clinical manifestations of adult diabetes are polydipsia,polyuria,polyphagia,and weight loss(the ‘three P's and one less').However,in children with T1DM,these symptoms are more pronounced,while T2DM may present more subtly.Traditional treatment for T1DM primarily involves insulin therapy,but it cannot fundamentally address the issue of impaired pancreatic function.Preventing or delaying β-cell damage and protecting the remaining pancreatic function have become new research directions in T1DM treatment.In addition to traditional insulin therapy and lifestyle interventions,new treatments such as immunotherapy,artificial pancreas,and stem cell transplantation have shown promising clinical results.These advances not only provide new directions for the future treatment of diabetes but also have the potential to transform diabetes from an incurable disease into a treatable one.

关 键 词：儿童糖尿病 1型糖尿病 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]