胰岛素强化治疗糖尿病患者发生低血糖的相关危险因素

The risk factors related with incidence of hypoglycemia in patients with diabetes mellitus after intensive insulin therapy

目的探讨糖尿病患者进行胰岛素强化治疗低血糖的发生率及危险因素。方法选择2型糖尿病患者265例进行胰岛素强化治疗,并进行病史收集、生化指标检测和血糖监测,分析低血糖发生情况及其危险因素。结果 68例患者出现低血糖,低血糖发生率为25.66%。多因素Logistic回归分析显示年龄[OR=3.46,95%CI(1.58~8.24)]、病程[OR=2.67,95%CI(1.87~5.36)]、肌酐[OR=1.24,95%CI(1.03~1.64)]、BMI[OR=0.56,95%CI(0.33~0.87)]和空腹C肽[OR=0.67,95%CI(0.32~0.89)]是低血糖发生的独立危险因素。结论对糖尿病患者进行胰岛素强化治疗时,当患者具有高龄、病程长、肌酐高、体重指数(BMI)低和空腹C肽低等低血糖的危险因素时,应注意加强血糖监测,防范低血糖的发生。

Objective To investigate the incidence rate of hypoglycemia and its risk factors in patients with diabetes mellitus after intensive insulin therapy. Methods A total of 265 patients with type 2 diabetes mellitus who were treated in our hospital from January 2015 to December 2015 were enrolled in the study. These patients were treated by intensive insulin therapy,then,patient ＇s medical history was collected,biochemical indicators and blood glucose levels were detected,moreover,the incidence rate of hypoglycemia and its risk factors were analyzed. Results Sixty-eight patients had hypoglycemia,with incidence rate of hypoglycemia being 25. 66%. The multi-factor Logistic regression analysis showed age[OR = 3. 46,95% CI（ 1. 58 ～ 8. 24） ],course of disease [OR = 2. 67,95% CI（ 1. 87 ～ 5. 36） ],creatinine [OR = 1. 24,95% CI（ 1. 03 ～ 1. 64） ],BMI [OR = 0. 56,95% CI（ 0. 33 ～ 0. 87） ]and fasting C peptide were the independent risk factors of incidence of hypoglycemia. Conclusion The blood glucose monitoring should be strengthened when patients with diabetes mellitus are treated by intensive insulin therapy,especially for the patients with older age,longer disease course,higher creatinine,lower BMI and lower fasting C peptide levels,so as to prevent the incidence of hypoglycemia.