住院老年2型糖尿病空腹低血糖分析

Analysis of Fasting Hypoglycemia in Hospitalized Elderly Patients with Type 2 Diabetes Mellitus

摘要: 目的：回顾性分析住院老年2型糖尿病(T2DM)患者空腹低血糖(空腹血糖≤3.9 mmol/L)发生状况，分析不同胰岛素种类其空腹低血糖发生情况，为老年糖尿病治疗提供参考依据。方法：通过我院住院患者数据库，检索2012年1月1日至2018年7月31日在我院住院的年龄65岁及以上的T2DM患者，1) 根据用药是否包含胰岛素分为胰岛素组(1组)和非胰岛素组(2组)。2) 应用预混胰岛素的患者为A组，应用长效胰岛素的患者为B组。3) 依据出院科室分组，内分泌科患者为C组，非内分泌科患者为D组，比较各组空腹低血糖发生率有无差异。结果：1) 2组空腹低血糖发生率高于1组(P < 0.05)；按照年龄分层后差异有统计学意义(P < 0.05)。2) A组空腹低血糖发生率高于B组(P = 0.001)；按照年龄分层后，[75, 80]及80岁以上年龄段差异有统计学意义(P < 0.05)。3) C组患者空腹低血糖发生率与D组无差异(P > 0.05)；C组预混胰岛素应用比例低于D组(P < 0.05)。4) 在空腹血糖≤3.9 mmol/L的患者中，应用最多的降糖方案为口服降糖药物联合胰岛素(32.09%)，其次为单用胰岛素者(24.04%)，单用口服降糖药物者比例最少(20.94%)。结论：随年龄增加，老年T2DM患者空腹低血糖发生率呈逐渐升高的趋势；年龄在75岁及以上的T2DM患者中，应用预混胰岛素空腹低血糖发生率更高。

Abstract: Objective: To retrospectively analyze the occurrence of fasting hypoglycemia in elderly patients with type 2 diabetes mellitus in Qingdao University Affiliated hospital, and to analyze the difference of incidence of fasting hypoglycemia in different insulin types and hypoglycemic regimens, and to provide reference for the treatment of senile diabetes mellitus. Methods: Through the database of inpatients in our hospital, the type 2 diabetic patients aged 65 and above who were hospitalized at Qingdao University Affiliated hospital from January 1, 2012 to July 31, 2018 were retrieved, 1) The patients were divided into insulin group (group 1) and non-insulin group (group2) according to whether insulin was included in the medicine. 2) The patients with hypoglycemic drugs containing premixed insulin were group A and group B with long-acting insulin. 3) According to the group of discharged departments, the endocrine department is group C, non-endocrine patients are group D, compare the incidence of fasting hypoglycemia in different groups. Results: 1) In hospitalized elderly patients with type 2 diabetes mellitus, the incidence of fasting hypoglycemia in group 2 was higher than that in group 1, (P < 0.05); after grouping according to age, there was significant difference between the two groups (P < 0.05). 2) The incidence of fasting hypoglycemia in Group A was higher than that in group B (P = 0.001); after grouping according to the age, in patients between [75, 80] and above 80 years old, the incidence of fasting hypoglycemia in group A was higher than that in group B (P < 0.05). 3) Grouping by department, there was no difference between the incidence of fasting hypoglycemia in group C and group D (P > 0.05); the proportion of premixed insulin used in group C was lower than group D (P < 0.05). 4) In patients with fasting blood glucose ≤ 3.9 mmol/L, the most widely used hypoglycemic scheme is oral hypoglycemic drug combined with insulin (32.09%), followed by insulin alone (24.04%), oral hypoglycemic drugs alone accounted for the least proportion (20.94%). Conclusion: With the increase of age, the incidence of fasting hypoglycemia in elderly patients with T2DM increased gradually; the incidence of fasting hypoglycemia with premixed insulin was higher in type 2 diabetic patients aged 75 years and over.