老年2型糖尿病患者动态血糖监测下夜间低血糖与认知功能的关系

Relationship between nocturnal hypoglycemia and cognitive function in aged type 2 diabetic patients

回顾性分析211例老年2型糖尿病患者的病例资料，包括动态血糖监测系统（CGMS）连续3d血糖监测资料，简易智能状态量表（MMSE）评估认知功能的数据。211例的低血糖发生率为47％（100／211），夜间低血糖者占总低血糖者的82％（82／100）。低血糖组和非低血糖组的MMSE评分分别为（25．1±5．1）和（26．8±3．0）分（P〈0．05）。MMSE评分≤24分者发生（夜间）低血糖比例较高（两组发生低血糖率分别为64％与43％，发生夜间低血糖者分别为51％和35％），低血糖最长时间较长[两组低血糖最长时间分别为40（0—140）与0（0～80）min，夜间低血糖最长时间分别为20（0—140）与0（0—70）min]（均P〈0．05）。夜间低血糖总时间及最长时问、年龄、文化程度是影响MMSE分数的因素。

Two hundred and eleven aged patients with type 2 diabetes were enrolled in the study. Blood glucose levels were monitored with continuing glucose monitoring system （CGMS） for 3 days and the cognitive function was evaluated with Mini-Mental State Examination（MMSE） scale. The correlation between hypoglycemia（or nocturnal hypoglycemia） and MMSE scores was evaluated. CGMS recorded hypoglycemia in 47% patients （ 100/211 ）, 82% of whom （ 82/100 ） had nocturnal hypoglycemia. Patients with hypoglycemia had lower MMSE scores than those without hypoglycemia （25. 1 ± 5. 1 vs. 26. 8 ± 3.0, P 〈0. 05）. Furthermore, the incidence of hypoglycemia（or nocturnal hypoglycemia） was higher in patients with MMSE ≤24 than that in patients with MMSE 〉 24 （ P 〈 0. 05 ）. The median of hypoglycemia maximal time and nocturnal hypoglycemia maximal time were longer in patients with MMSE≤ 24 than those with MMSE 〉 24 （P 〈 0. 05 ）. Stepwise regression analysis showed that the total time and maximal time of hypoglycemia（ or nocturnal hypoglycemia）, age, and education level were the main factors intluencing MMSE scores in axed type 2 diabetic patients（ all P 〈0. 05 ）.