胰岛素泵治疗2型糖尿病围手术期低血糖发生率及影响因素分析

Xiaohua Lu, Youshuang Zhu, Wane Zhao, Yan Liu, Xixi Luo, Yan Zhou
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引用次数: 0

摘要

目的:了解胰岛素泵治疗围手术期糖尿病患者低血糖的发生率及相关因素。方法:对接受胰岛素泵治疗的2型糖尿病患者进行回顾性队列研究。所有患者根据是否发生低血糖分为低血糖组和非低血糖组。收集两组患者的临床特点及治疗方法进行比较。我们估计低血糖的发生率,并通过多变量logistic回归确定与低血糖相关的因素。结果:88例(39.8%)患者共发生低血糖172次,其中1级(<3.9 mmol/L) 146例(84.9%),2级(< 3.0 mmol/L) 26例(15.1%)。本研究无严重低血糖(3级)报告。多变量logistic回归模型结果发现,使用泵时间越长的糖尿病患者发生低血糖的可能性越大(AOR=1.09, 95% CI=1.04-1.15)。然而,那些BMI和eGFR较高的糖尿病患者发生低血糖的可能性较小(AOR=0.86, 95% CI=0.76-0.98;AOR=0.86, 95% CI=0.76-0.98)。结论:胰岛素泵治疗围手术期糖尿病患者易发生轻中度低血糖。围手术期长期接受胰岛素泵治疗,BMI和eGFR较低,使2型糖尿病发生低血糖的风险较高。它可以帮助医疗保健提供者筛选接受长期胰岛素泵治疗的2型糖尿病患者的低血糖。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidence and Factors of Hypoglycemia in Perioperative Patients with Type 2 Diabetes Mellitus on Insulin Pump Therapy
Objective: To estimate the incidence of and identified factors associated with hypoglycemia among perioperative diabetes patients with insulin pump therapy. Methods: This was a retrospective cohort study of type 2 diabetes patients with insulin pump therapy newly received surgery. All patients were divided into hypoglycemia group and non-hypoglycemia group according to whether they experienced hypoglycemia. Information about clinical characteristics and treatments were collected and compared between two groups. We estimated the incidence of hypoglycemia, and identified factors associated with hypoglycemia by using multivariable logistic regression. Results: A total of 172 episodes of hypoglycemia were observed in 88 (39.8%) patients, among which, 146 (84.9%) were level 1 hypoglycemia (<3.9 mmol/L) and 26 (15.1%) were level 2 (< 3.0 mmol/L). No severe hypoglycemia (level 3) was reported in this study. Results from the multivariable logistic regression model found that diabetes patients with a longer duration of pump use were more likely to have hypoglycemia (AOR=1.09 with 95% CI=1.04-1.15). However, those diabetes patients who were with higher BMI and eGFR were less likely to have hypoglycemia (AOR=0.86 with 95% CI=0.76-0.98; AOR=0.86 with 95% CI=0.76-0.98, respectively). Conclusion: Perioperative diabetes patients with insulin pump therapy were prone to develop mild to moderate hypoglycemia. The long-term of receiving insulin pump therapy during the perioperative period, with lower BMI and eGFR, put type 2 diabetes at higher risks in hypoglycemia. It may help healthcare providers to screen hypoglycemia among type 2 diabetes patients with receiving long-term insulin pump therapy.
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