Inpatient Dietary Behaviour Score (IDBS) Predicts the Risk of Hypoglycemia in Type 2 Diabetes Mellitus (T2DM) Patients

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes/Metabolism Research and Reviews Pub Date : 2025-02-14 DOI:10.1002/dmrr.70035

Zhiping Liu, Jiangqiong Chen, Qing Liang, Wenjin Luo, Qingfeng Cheng, Qifu Li, Mei Mei, Liping Zan

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Abstract

Aims

The aim of this study was to develop the inpatient dietary behaviour score (IDBS) and validate its predictive performance in assessing the risk of hypoglycemia in patients with type 2 diabetes mellitus (T2DM).

Methods

The study included patients with T2DM admitted to the Endocrinology Department of the First Affiliated Hospital of Chongqing Medical University between 1 March 2021 and 1 March 2023. Patients were categorised into hypoglycemia and non-hypoglycemia groups using a paired approach, with hypoglycemia defined as any point-of-care glucose test results ≤ 3.9 mmol/L. Clinical data were collected, and the IDBS was calculated using a self-designed scale with 11 variables. Subsequently, measures for predicting hypoglycemia risk in hospitalised T2DM patients were formulated.

Results

A total of 1478 patients were included in the survey, with 739 patients in each of the hypoglycemic and non-hypoglycemic groups after pairing. Baseline differences were observed in education, marital status, job status, DM duration, glycosylated haemoglobin A1c (HbA1c), body mass index (BMI), hypoglycemia history, diabetic peripheral artery disease (DM-PAD), diabetic foot (DF), diabetic kidney disease (DKD), and diabetic retinopathy (DR) between the hypoglycemic and non-hypoglycemic groups. Significant correlations were found between the updated and baseline changes in the IDBS. The predictive efficacy was highest in DKD patients (OR = 1.82, 95% CI: 1.69–1.97, P = 6.75E-53). In multivariate analyses, only BMI, DM duration, diabetic foot and marriage response were included in the regression model. The area under the curve (AUC) and mean squared error (MSE) of the IDBS were 0.77 and 0.00039, respectively. A linear relationship existed between the IDBS and OR values, indicating that the risk of hypoglycemia increased with higher scores.

Conclusions

IDBS demonstrated a robust predictive effect on hypoglycemia. The variable data were easily obtainable, and the evaluation and calculation methods were straightforward. This scoring system could serve as a valuable reference for hypoglycemia prevention and screening of hospitalised diabetic patients at high risk of hypoglycemia.

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住院患者饮食行为评分（IDBS）预测2型糖尿病（T2DM）患者低血糖的风险

目的本研究的目的是建立住院患者饮食行为评分（IDBS），并验证其在评估2型糖尿病（T2DM）患者低血糖风险中的预测作用。方法研究纳入2021年3月1日至2023年3月1日重庆医科大学第一附属医院内分泌科收治的T2DM患者。采用配对方法将患者分为低血糖组和非低血糖组，低血糖定义为任何护理点血糖试验结果≤3.9 mmol/L。收集临床资料，采用自行设计的包含11个变量的量表计算IDBS。随后，制定了预测住院T2DM患者低血糖风险的措施。结果共纳入1478例患者，配对后低血糖组和非低血糖组各739例。观察低血糖组与非低血糖组在教育程度、婚姻状况、工作状态、糖尿病病程、糖化血红蛋白A1c （HbA1c）、体重指数（BMI）、低血糖史、糖尿病外周动脉疾病（DM- pad）、糖尿病足（DF）、糖尿病肾病（DKD）、糖尿病视网膜病变（DR）等方面的基线差异。IDBS的更新和基线变化之间存在显著相关性。DKD患者的预测疗效最高（OR = 1.82, 95% CI: 1.69 ~ 1.97, P = 6.75E-53）。在多变量分析中，回归模型只包括BMI、糖尿病病程、糖尿病足和婚姻反应。IDBS曲线下面积（AUC）和均方误差（MSE）分别为0.77和0.00039。IDBS与OR值之间存在线性关系，表明低血糖的风险随着得分的增加而增加。结论IDBS对低血糖有较强的预测作用。变量数据容易获取，评价和计算方法简单。该评分系统可为低血糖预防和低血糖高危住院糖尿病患者的筛查提供有价值的参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes/Metabolism Research and Reviews 医学-内分泌学与代谢

CiteScore

17.20

自引率

2.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.