2型糖尿病老年患者发生低血糖的影响因素及应对策略

Influencing factors and coping strategies of hypoglycemia in elderly patients with type 2 diabetes

目的探讨老年2型糖尿病患者发生低血糖的危险因素,针对危险因素提出解决策略。方法选取2017年6月至2018年9月在本院就诊的老年2型糖尿病患者288例作为研究对象,收集患者的临床资料,采用多因素logistic回归分析确定影响老年糖尿病患者发生低血糖的危险因素。结果67例患者发生低血糖,多因素分析显示,2型糖尿病老年患者中,病程>10年的患者发生低血糖的风险较病程≤10年患者高(P<0.05);未进行自我血糖监测的患者发生低血糖的风险较自我监测血糖的患者高(P<0.05);使用胰岛素的患者发生低血糖的风险较不使用胰岛素的患者高(P<0.05);使用磺脲类药物的患者发生低血糖的风险较不用磺脲类药物的患者高(P<0.05);联合使用降糖药的患者发生低血糖的风险较不联合应用降糖药的患者高(P<0.05)。结论对于老年2型糖尿病患者加强血糖的自我监测,掌握患者血糖基本情况,注意根据患者情况调整用药非常重要。

Objective To explore the risk factors of hypoglycemia in elderly patients with type 2 diabetes,and propose solutions for the risk factors.Methods We selected 288 cases of elderly patients with type 2 diabetes who were treated in our hospital from June 2017 to September 2018 as the study subjects.The clinical data of the patients were collected and the risk factor of hypoglycemia in elderly diabetic patients was determined by multivariate logistic regression analysis.Results Among them,67 cases of patients developed hypoglycemia.Multivariate analysis showed that in elderly patients with type 2 diabetes,the risk factor of hypoglycemia in patients with a course of>10 years was higher than that in patients with a course of≤10 years(P<0.05),patients without self-monitoring blood glucose had a higher risk of hypoglycemia than patients with self-monitoring blood glucose(P<0.05),patients with insulin had a higher risk of hypoglycemia than patients without insulin(P<0.05),patients with sulfonylureas had a higher risk of hypoglycemia than patients without sulfonylureas(P<0.05),and patients who combined use hypoglycemic drugs had a higher risk of developing hypoglycemia than those who didn't combined use hypoglycemic drugs in(P<0.05).Conclusion It was very important for elderly patients with type 2 diabetes to strengthen self-monitoring of blood glucose,grasp the basic situation of blood glucose of patients,and pay attention to adjuste medication according to the situation of patients.