Glycaemic control and microvascular complications among paediatric type 2 diabetes mellitus patients in Hong Kong at 2 years after diagnosis
Year: 2024
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Type 2 diabetes mellitus (T2DM) is becoming increasingly common among children and adolescents worldwide, including those in Hong Kong. This study analysed the characteristics and prevalence of microvascular complications among paediatric T2DM patients in Hong Kong at diagnosis and 2 years after diagnosis. METHODS: All patients aged <18 years who had been diagnosed with DM at public hospitals in Hong Kong were recruited into the Hong Kong Childhood Diabetes Registry. Data collected at diagnosis and 2 years after diagnosis were retrospectively retrieved from the Registry for patients diagnosed from 2014 to 2018. RESULTS: Median haemoglobin A1c (HbA1c) levels were 7.5% (n=203) at diagnosis and 6.5% (n=135) 2 years after diagnosis; 59.3% of patients achieved optimal glycaemic control (HbA1c level <7%) at 2 years. A higher HbA1c level at diagnosis was associated with worse glycaemic control at 2 years (correlation coefficient=0.39; P<0.001). The presence of dyslipidaemia (adjusted odds ratio [aOR]=3.19; P=0.033) and fatty liver (aOR=2.50; P=0.021) at 2 years were associated with suboptimal glycaemic control. Diabetic neuropathy and retinopathy were rare in our cohort, but 18.6% of patients developed microalbuminuria (MA) within 2 years after diagnosis. Patients with MA had a higher HbA1c level at 2 years (median: 7.2% vs 6.4%; P=0.037). Hypertension was a risk factor for MA at 2 years, independent of glycaemic control (aOR=4.61; P=0.008). CONCLUSION: These results highlight the importance of early diagnosis and holistic management (including co-morbidity management) for paediatric T2DM patients.
Source: Hong Kong Medical Journal
DOI: 10.12809/hkmj2210552
Authors: WI Yam, Shirley MY Wong, PT Cheung, Elaine YW Kwan, YY Lam, LM Wong, KL Ng, Sammy WC Wong, CY Lee, MK Tay, KT Chan, Antony CC Fu, Joanna YL Tung, Gloria SW Pang, HC Yau, Queenie WS See, Priscilla WC Lo, Sharon WY To, HW Yuen, Jacky YK Chung, Eunice WY Wong, Sarah WY Poon, Charlotte HY Lam, Suki SY Chan, Janez HC Tsui, Cindy SY Chan, Betty WM But
Institutions: Queen Elizabeth Hospital, Alice Ho Miu Ling Nethersole Hospital, Queen Mary Hospital, University of Hong Kong, Pamela Youde Nethersole Eastern Hospital, Kwong Wah Hospital, Tuen Mun Hospital, United Christian Hospital, Caritas Medical Centre, Tseung Kwan O Hospital, Princess Margaret Hospital, Hong Kong Children's Hospital, Prince of Wales Hospital
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4401624824