门诊糖尿病患者强化血糖管理方案发生低血糖事件的分析

The analysis of the hypoglycemic events induced by intensified hypoglycemic therapy in diabetic outpatients

目的探讨门诊糖尿病患者强化血糖管理方案的低血糖事件发生原因及安全性。方法选取门诊就诊且接受强化管理方法的糖尿病患者36例做定期随访,收集低血糖发生情况,包括低血糖性质、类型及发生原因,并进行分析。结果对36例患者随访216次,低血糖发生率为66.2%(143/216)。导致低血糖发生的主要原因为不明原因[31.5%(45/143)]和运动过度[23.1%(33/143)]。>60岁的糖尿病患者低血糖发生率较<60岁的患者高(P=0.041),未规律监测血糖患者低血糖的发生率较监测血糖患者高(P=0.004)。结论糖尿病患者中症状性低血糖所占比例最高,以不明原因低血糖发生率最高。年龄越高和自测血糖意识薄弱者低血糖发生率升高,强化血糖监测可以发现低血糖的发生并进行有效的预防。

Objective To explore the benefits of strenthening management of outpatient diabetic patients with hypoglycemia and its safety. Methods The 36 outpatient diabetic patients receiving strengthening diabetes management were regularly follow-up for hypoglycemic characteristic, types and causes. Results The incidence of hypoglycemia was 66.2% （143/216） ,the main causes of hypoglycemia were idiopathic hypoglycemia [31.5%（45/143）] and excessive exercise [-23. 1%（33/143）]. Patients aged〉60 years and patients who did not self-monitor blood glucose had higher prevalence of developing hypoglycemia （P = 0. 041, P = 0. 004, respectively）. Conclusion Symptomatic hypoglycemia has the greatest proportion in diabetic patients, and the main cause of hypoglycemia is idiopathic. Patients aged 60 years and patients who do not self-monitor blood glucose have a higher prevalence of hypoglycemia. Therefore, strengthening blood glucose monitoring can prevent the occurrence of hypoglycemia.