| Objective: Analysis new profile of hospitalized patients with type 1 diabetes,in recent five years in shandong provincial hospital endocrinology comprehensive,summarizes the clinical characteristics, provide reference for the diagnosis and treatment of type 1 diabetes.Methods: Medical records of access ways, through screening since January 1, 2011 to December 31, 2015, a total of 116 cases of endocrinology in shandong provincial hospital wards, and hospitalization for patients with type 1 diabetes, a detailed record of the patient's sex, age, cause of hospital, come on in, height, weight, BMI index, the onset of the clinical symptoms, blood sugar, glycosylated hemoglobin, fasting insulin, fasting c-peptide, beta hydroxy butyric acid, glycosuria, urine ketone, diabetes related antibody(ICA, IAA, GAD), blood lipid metabolism(TG, HDL, LDL and CHOL), thyroid related indicators(TSH, TPO, Trab, Tgab), the presence of a strong family history of diabetes, insulin treatment after discharge, such as data, according to patients' gender, age, medical reasons, clinical characteristics, discharge insulin group, using spss22.0 statistical software for statistical analysis.Results: 1 according to the clinical characteristics and references will be divided into 116 patients with acute type immune-mediated(classic) type 1 diabetes type 1 diabetes, 97 people, accounted for 83.62% of new diagnostic T1DM; Slow hair immune-mediated that adults with type 1 diabetes underlying autoimmune diabetes(LADA) patients, 14, accounted for 12.07% of new diagnostic T1 DM patients; Idiopathic type 1 diabetes(fulminant type 1 diabetes) 5 people, accounting for 4.31% of the new diagnosis in patients with T1 DM. Shandong provincial hospital endocrinology, 2 in recent five years to receive the new hair in the largest number of patients with type 1 diabetes on December January(15 cases),(13 cases), march(12 cases), the minimum number of months on September(6 cases), November(6 cases), August(7 cases), the largest number of people in not more than 2 times the average monthly treated.through three classic 9 cases of patients with type 1 diabetes mellitus and the metabolic syndrome and merger of LADA 4 cases of patients with metabolic syndrome, two groups of patients in blood sugar, urine ketone, weight changes, the ICA antibodies and clinical symptoms have significant difference(P<0.05), but in the TG, HDL, LDL and CHOL, BMI, there was no significant difference(P ?0.05);3 different reasons with the first classic with type 1 diabetes can be divided into DKA group(86 cases) and non DKA group(11 cases), the young group(9-14 years old) patients with DKA is the primary reason for 82.76%, 94.34% young(15 to 35 years old) patients with DKA is the primary reason, in the elderly group(36-63 years) patients with DKA is the primary reason for 80%; In DKA group and non DKA, GAD positive rate of resistance, between Hb A1 c level and primary medical reasons have significant difference(P < 0.05), but the rate of positive of antibody of ICA, IAA, lipid metabolism, blood glucose levels and the primary reason why there was no significant difference between(P 0.05) or higher.5 in 116 cases of the new type 1 diabetes patients, in 97 cases of new classic in patients with type 1 diabetes, gender differences and the primary reason of different treatment, and patients had no significant difference between the presence of a strong family history of diabetes. "Six men in newly diagnosed type 1 diabetes classic in 49 cases, 48 cases, women HDL levels and classic the gender of the patients with type 1 diabetes have significant difference(P=0.024), and other related lipid metabolic indices such as LDL, TG, CHOL, blood glucose, Hb A1 c, no significant gender differences between men and women; In terms of GAD antibody, female patients was significantly higher than that of male patients, but in terms of ICA, IAA antibody detection rate, there was no significant gender differences; Such as dry mouth drink more, feed more easy hunger, fatigue and so on clinical symptoms, there was no significant difference between male and female patients.7 according to BMI classic with type 1 diabetes can be divided into low, standard, three groups of overweight, eliminate aged under 18 patients at the same time, the relationship between gender and body weight between the three groups of patients with no significant difference(P = 0.636). Three groups of relations between islet autoantibody positive detection rate and weight had significant difference(P = 0.016), especially the GAD antibody positive rate and weight shows significant difference(P = 0.002). Low group compared with the standard group, the onset of patients age, blood sugar and weight with significant difference(P = 0.040, P = 0.016), Hb A1 c, and weight there was no significant difference(P = 0.059); Standard and overweight compared to thyroid related antibodies such as TPO, Tgab value and weight show significant difference(P = 0.017, P = 0.003), lipid metabolism related, such as the level of HDL and LDL, TG, CHOL, there was no significant difference with weight; Underweight and overweight compared to TPO and weight had significant difference between(P = 0.017), there is significant difference between HDL and weight(P = 0.034), while other thyroid related antibodies, such as the value of Trab, Tgab, other lipid metabolism related indicators such as LDL, TG, CHOL, numerical, there was no significant difference with weight. "According to the age of 8 classic with type 1 diabetes can be divided into young group(9-14), in young(15 to 35 years old) and elderly group(36-63), a young group compared with young group, TG level and age have significant difference(P = 0.024), and other lipid metabolism indexes such as the level of HDL, LDL and CHOL, with age, there was no significant difference; Young group compared with in the elderly group, BMI and age show significant correlation(P = 0.029), and other lipid metabolism related, such as the level of HDL and LDL, TG, CHOL, there was no significant difference with weight. 9 according to the scheme of insulin at the beginning of patients discharged from hospital, divided into the plan 1(base long-acting insulin + short-acting insulin before meals, a total of 71 cases), 2(premixed insulin twice, a total of 34 cases), patients' age, gender, Hb A1 c, insulin, C peptide level and discharge when choose scheme has significant difference; Patient classification(LADA or classic type 1), the primary reason(DKA and non DKA) treatment, insulin use no significant difference at discharge.Conclusion: 1 nearly five years new number of people with type 1 diabetes increased year by year but the trend is stable, no explosive growth and decreased obviously. Is the maximum number of classic type 1 diabetes, fulminant type 1 diabetes in the least.2 type 1 diabetes mellitus and metabolic syndrome in patients with all ages are, classic type 1 diabetes mellitus and metabolic syndrome in patients with blood sugar, weight variation, ICA positive rate, significantly higher than the lady merger in patients with metabolic syndrome.3 DKA is the leading cause of doctor for new type 1 diabetes, patients with DKA onset of Hb A1 c level higher, GAD positive rate is bigger.4 in the classic with type 1 diabetes, women with HDL- C level, GAD antibody positive rate significantly higher than that of male patients; Standard weight patients with GAD were greater than light, overweight patients; The smaller the weight, the higher the HDL, TPO level; The smaller the age, the lower the TG level.5 insulin, C peptide level is higher, the greater the onset age, Hb A1 c level is lower, the hospital pre-mixed insulin insulin solution, the more inclined to 2nd. |
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