2型糖尿病老年患者发生低血糖的危险因素及护理对策

Risk Factors and Nursing Countermeasures of Hypoglycemia in Elderly Patients with Type 2 Diabetes Mellitus

目的分析2型糖尿病老年患者发生低血糖的危险因素及护理对策。方法选取我院205例老年2型糖尿病患者,收集患者的性别构成、年龄、BMI、病程等资料,检测FBG水平、糖化血红蛋白(Hb A1c)、血肌酐,记录住院期间低血糖发生率和时间,并分析发生低血糖的危险因素。结果 205例患者中发生低血糖49例(23.9%),晚上临睡前低血糖发生率最高,占48.9%。多因素Logistic回归分析表明,影响发生低血糖的相关因素有4项:≥80岁、病程>20年、BMI<18.5 kg/m2、血肌酐≥149μmol/L。结论对于2型糖尿病老年患者,需加强合并危险因素患者的巡视及睡前等高危时段的血糖监测,避免发生低血糖。

Objective To analyze the risk factors and nursing countermeasures of hypoglycemia in elderly patients with type 2 diabetes mellitus. Methods 205 elderly patients with type 2 diabetes mellitus in our hospital were selected. The sex composition, age, BMI, disease course of patients were collected, the levels of FBG, HbAlc, serum creatinine were detected, the incidence and occurrence time of hypoglycemia were recorded, and the risk factors of hypoglycemia were analyzed. Results Of 205 patients, 49 cases （23.9%） developed hypoglycemia, the incidence was highest before going to sleep, which accounted for 48.9%. The results of multi-factor Logistic regression analysis showed that four factors affect the occurrence of hypoglycemia： patients＇ age ≥80, patients＇ disease course〉20 years, BMI〈18.5 kg/m% serum creatinine≥ 149/zmol/L. Conclusions For elderly patients with type 2 diabetes mellitus, it is necessary to strengthen the monitoring of blood glucose in patients complicating risk factors and at high-risk period （before going to bed）, thus avoiding hypoglycemia.