DataSheet_1_Glycated Hemoglobin (HbA1c) Concentrations Among Children and Adolescents With Diabetes in Middle- and Low-Income Countries, 2010–2019: A Retrospective Chart Review and Systematic Review of Literature.docx

ObjectivesTo explore the glycemic control [represented by glycated hemoglobin (HbA1c) concentrations] in children with diabetes mellitus (DM) in east China and middle- and low-income countries, from 2010 to 2019.
MethodsRetrospective data of children with DM from two hospital-based health records were reviewed. Data on HbA1c concentrations, hospitalization due to diabetic ketoacidosis, and patient demographics were collected and analyzed. A systematic review was subsequently performed to analyze publications that report HbA1c concentrations in patients aged <18 years. Patients’ characteristics extracted from each publication were used to generate simulated individual data for pooled analysis. HbA1c estimates were derived from steady-state iterations.
ResultsData of 843 diabetic children (aged 11.2 ± 3.9 years) with 2,658 HbA1c measures were retrieved from the two hospitals during the period 2010–2020. The duration of diabetes in the patients was 4.4 ± 2.8 years, and their HbA1c was 8.1 ± 2.2%. Patients who were internal migrants had significantly higher HbA1c concentration than resident patients (8.4 vs. 7.9%). The literature review yielded 1,164 publications, and the majority (74.1%) of patient data were published in high-income countries. The patient data extracted from these publications generated 486,416 HbA1c concentration estimates between 2005 and 2019. The average HbA1c concentration during the 15 years was 9.07 ± 2.15%. The mean HbA1c concentrations among children were 8.23, 8.73, 9.20, and 10.11% in high-income country (HIC), upper-middle income country (UMIC), lower-middle income country (LMIC), and low-income country (LIC) respectively. The mean rate of optimized glycemic control (HbA1c <7.5%) among children was 32.4, 27.5, 21.7, and 12.7% in HIC, UMIC, LMIC, and LIC, respectively.
ConclusionsThe current study indicated that there is substantial room for improvement in glycemic control in children with DM worldwide, especially in middle- and low-income countries.

研究目的：探讨2010至2019年华东地区及中低收入国家糖尿病（DM）患儿的血糖控制情况，以糖化血红蛋白（HbA1c）浓度作为评估指标。
研究方法：回顾性分析两家医院的糖尿病患儿医疗记录，收集并分析其糖化血红蛋白浓度、糖尿病酮症酸中毒住院情况及患者人口统计学资料。随后开展系统综述，对报道18岁以下患者糖化血红蛋白浓度的文献进行分析；从每篇文献中提取患者特征数据，生成模拟个体数据以进行合并分析，糖化血红蛋白估算值通过稳态迭代法得出。
研究结果：2010至2020年间，从两家医院共获取843例糖尿病患儿的相关数据，患儿平均年龄为11.2±3.9岁，累计完成糖化血红蛋白检测2658人次。患儿糖尿病病程为4.4±2.8年，平均糖化血红蛋白浓度为8.1±2.2%。流动人口患儿的糖化血红蛋白浓度显著高于常住患儿（8.4% vs 7.9%）。本次文献综述共检索到1164篇相关文献，其中74.1%的患者数据来自高收入国家（HIC）。从上述文献中提取的患者数据共生成2005至2019年间的486416条糖化血红蛋白浓度估算值，15年间的平均糖化血红蛋白浓度为9.07±2.15%。按国家收入水平划分，高收入国家（HIC）、中高收入国家（UMIC）、中低收入国家（LMIC）及低收入国家（LIC）患儿的平均糖化血红蛋白浓度分别为8.23%、8.73%、9.20%及10.11%。按血糖优化控制标准（糖化血红蛋白<7.5%）统计，高收入国家、中高收入国家、中低收入国家及低收入国家患儿的达标率分别为32.4%、27.5%、21.7%及12.7%。
研究结论：本研究表明，全球范围内糖尿病患儿的血糖控制水平仍存在较大提升空间，中低收入国家的改善需求尤为突出。