Objectives To investigate the clinical characteristics and therapy of type 2 diabetes mellitus (T2DM) in children. Methods The clinical records of 52 hospitalized children with T2DM from Jan. 2003 to Mar. 2012 were retrospectively analyzed. Results Eight (15.38%) of 52 patients (23 male and 29 female) were overweight, 33 patients (63.46%) were obese, and 33 patients (63.46%) had family history of diabetes and most of patients presented with typical symptoms. Six cases (11.54%) were complicated by diabetic ketoacidosis, 43 cases (82.69%) presented with dyslipidemia, and 22 cases (42.31%) had hypertension. 13 cases (25.00%) were with non-alcoholic fatty liver, and 3 female cases with polycystic ovary syndrome. The insulin resistance index (HOMA-IR) and insulin secretory function (HOMA-IS) were calculated in 24 patients. The HOMA-IR was elevated with blood glucose increased, but the difference was not statistically significant. For treatment, 2 cases (3.85%) were treated with dietary, exercise and behavior intervention, 10 cases (19.23%) with oral mctformin, and 15 cases (28.85%) with insulin administered subcutaneously, 25 cases (48.08%) with insulin combined with metformin. Eighteen patients were followed up. Conclusions T2DM usually occurs in the older and obese children. Its incidence is increasing each year. The patients has various clinical manifestations, and with β cell disfunction and insulin resistance. The compliance of patients were poor.%目的 探讨儿童2 型糖尿病(T2DM)的临床特征和诊治方法.方法回顾性分析2003 年1 月至2012 年3 月住院治疗的52 例T2DM 患儿的临床资料.结果 52 例T2DM 患儿中,男性23 例、女性29 例,超重8 例(15.38%)、肥胖33 例(63.46%),有糖尿病家族史33 例(63.46%),多数有典型症状.合并糖尿病酮症酸中毒6 例(11.54%),血脂异常43 例(82.69%),高血压22 例(42.31%),非酒精性脂肪肝13 例(25.00%);3 例女性患儿合并多囊卵巢综合征.24 例患儿检测计算胰岛素抵抗指数(HOMA-IR) 和胰岛素分泌功能 (HOMA-IS),显示HOMA-IR 随血糖而升高,但差异无统计学意义.予饮食、运动和行为矫正干预治疗2 例(3.85%),口服二甲双胍治疗10 例(19.23%),皮下注射胰岛素治疗15 例(28.85%),皮下注射胰岛素联合口服二甲双胍治疗25 例(48.08%).接受随访18 例(34.62%).结论儿童T2DM 多见于年长肥胖儿童,发病率呈逐年上升趋势,临床表现多样,有β细胞功能损害及胰岛素抵抗,其治疗依从性低.
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