通讯作者: 王涛, wangtao19830828@163.com

DOI：10.12201/bmr.202412.00069

Analysis of risk factors for hypoglycemia in elderly outpatients with type 2 diabetes

• 摘要：目的 评估该地区门诊老年2型糖尿病(T2DM)患者低血糖的患病率及发生低血糖事件的相关危险因素。方法 收集 2023年1月1日至 2024 年 1月 1 日在高密市中医院内分泌科门诊就诊,年龄超过60岁并确诊为2型糖尿病的患者。通过电子病历获得一般情况、用药史和合并症等相关变量。低血糖的发生率是通过患者就诊期间的问诊及血糖监测来确定的。应用Logistic回归模型确定与低血糖和入院/急诊就诊相关的因素。结果 1. 老年T2DM患者发生低血糖的现状320例2型糖尿病患者中,61例发生低血糖,19.1%的患者普遍存在低血糖,低血糖组的患者年龄更大,糖尿病病程较长,有较高的糖尿病家族史。2.低血糖分级 重度低血糖的发生率为11.5%,中、轻度低血糖的发生率分别为32.8%和 55.7%。3. 在糖尿病合并症方面,低血糖患者的合并症总数多于非低血糖组,但无显著统计学差异(P = 0.567)。4.在降糖药物的使用上,低血糖患者应用胰岛素的比例更高,其他降糖药物的应用无明显差别。5.T2DM患者发生低血糖的多因素分析 糖尿病病程≥10 年,应用胰岛素是发生低血糖的危险因素,高脂血症为 2 型糖尿病患者发生低血糖的保护因素6. 低血糖的发生(OR=1.890, 95%CI:1.101～2.987, P=0.017),是住院或急诊科就诊的高危因素,具有统计学意义；受教育程度(高中以上)(OR=0.872,95%CI:0.587～2.506, P=0.031),是住院或急诊科就诊的保护因素。结论 门诊老年2型糖尿病患者低血糖事件发生率较高,糖尿病病程≥10 年,应用胰岛素是发生低血糖的危险因素,高脂血症为 2 型糖尿病患者发生低血糖的保护因素。此外,对糖尿病认知的不足及低血糖使老年 2 型糖尿病患者急诊就诊和入院率增加。

  关键词： 低血糖; 门诊; 老年; 危险因素

   

  Abstract: Objective Assess the prevalence of hypoglycemia and the associated risk factors among elderly outpatients with type 2 diabetes mellitus (T2DM) in the region..Method Collect patients diagnosed with type 2 diabetes mellitus over 60 years old who visited the Endocrine department of Gao Mi Traditional Hospital from January 1, 2023, to January 1, 2024. General information, medical history, and comorbidities were obtained through electronic medical records. The incidence of hypoglycemia was determined by patient interviews and blood glucose monitoring during the clinic visit. A logistic regression model was applied to identify factors associated with hypoglycemia and admission/emergency department visits.Result 1. The current situation of hypoglycemia in elderly patients with type 2 diabetes mellitus: among 320 cases of type 2 diabetes mellitus, 61 cases experienced hypoglycemia, indicating a prevalence of 19.1%. Patients in the hypoglycemia group were older, had longer duration of diabetes, and had a higher rate of diabetes family history. 2. Grading of hypoglycemia: The incidence rate of severe hypoglycemia was 11.5%, while that of moderate and mild hypoglycemia was 32.8% and 55.7%, respectively. 3. Regarding diabetes complications, hypoglycemic patients had a higher total number of complications than the non-hypoglycemic group, but there was no significant statistical difference (P=0.567). 4. Regarding the use of hypoglycemic drugs, hypoglycemic patients had a higher usage rate of insulin, while the use of other hypoglycemic drugs showed no significant difference. 5. Multifactor analysis of hypoglycemia in patients with type 2 diabetes mellitus: Diabetes duration≥10 years and application of insulin were identified as risk factors for hypoglycemia, while hyperlipidemia was a protective factor for hypoglycemia in patients with type 2 diabetes mellitus. 6. Hypoglycemia (OR=1.890, 95%CI:1.101～2.987, P=0.017) was a high-risk factor for hospitalization or emergency department visits and had statistical significance. Education level (high school and above) (OR=0.872,95%CI:0.587～2.506, P=0.031) was a protective factor for hospitalization or emergency department tvisits.Conclusion Elderly patients with type 2 diabetes mellitus in outpatient settings have a high incidence of hypoglycemic events. Diabetes duration≥10 years and application of insulin were identified as risk factors for hypoglycemia, while hyperlipidemia was a protective factor for hypoglycemia in patients with type 2 diabetes mellitus. In addition, inadequate understanding of diabetes and hypoglycemia increases the rates of emergency department visits and hospitalizations in elderly patients with type 2 diabetes mellitus.

  Key words: Hypoglycemia; Outpatient; Elderly; Risk factors

  提交时间：2024-12-28

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• 序号	提交日期	编号	操作
  1	2024-10-23	bmr.202412.00069V1	下载

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