老年糖尿病患者院外发生低血糖的相关因素分析

Risk factors of hypoglycemia about elderly patients with diabetes out the hospital

目的探讨老年糖尿病患者院外发生低血糖的原因,以指导今后临床、门诊、社区的糖尿病教育工作,为出院的糖尿病患者的随访管理提供指导性建议。方法选择2010年1~12月曾在本院住院的老年糖尿病患者,3个月内密切随访,将曾发生低血糖事件的46名糖尿病患者纳入分析,通过频数分析得出老年糖尿病患者院外发生低血糖的原因。结果 46名患者在本院住院期间通过血糖控制和糖尿病教育,患者各项糖脂代谢指标均较住院前明显降低（P〈0.05和P〈0.01）。频数分析显示,老年糖尿病患者院外低血糖的危险因素主要与饮食、药物、疾病、运动、血糖监测等几方面相关。结论老年糖尿病患者院外发生低血糖事件主要与患者饮食不当、不合理用药、合并全身疾病病情复杂、不合理运动、未进行血糖监测等有关。在今后糖尿病的教育中应注重个体化的糖尿病教育,并对患者进行出院后的定期电话随访及指导,以减少低血糖事件。

Objective To analysis the factors that induced hypoglycemia in elderly patients with diabetes,and then to guide the diabetic education in clinical,outpatient and community and provide advice when they follow-up. Methods Selected the elderly patients with diabetes who were in hospital from January to December in 2010,and then got follow-up frequently,46 patients who got hypoglycemia were included in our study,we got the reasons of the hypoglycemia,and guided the diabetic education. Results After the control of blood glucose and diabetic education,the parameters of glucose and lipid metabolism were significantly lower than in the beginning（ P〈0.05 and P〈0.01）. The risk factors of hypoglycemia were related with diet,drugs,disease,exercise,blood glucose monitoring. Conclusion Patients with hypoglycemia in elderly diabetic persons were mainly related with unnormal diet,complex systemic disease status,improper exercise and do not monitor the blood glucose. In order to avoid hypoglycemia,we should focus on individualized diabetes education and keep in touch with patients by periodic telephone follow-up in the future.