儿童1型糖尿病低血糖事件的影响因素分析

Analysis of Factors Influencing Hypoglycemic Events in Children with Type 1 Diabetes Mellitus

目的:分析儿童1型糖尿病(T1DM)低血糖事件的影响因素。方法:回顾性分析2018年1月—2022年4月于贵阳市妇幼保健院就诊的100例T1DM患儿的临床资料,将发生低血糖的62例纳入A组,未发生低血糖的38例纳入B组,分析比较两组的一般资料;于8个时间段内(三餐前和三餐后2 h、睡前和凌晨2点)对所有患儿进行定点血糖监测,并采用logistic回归分析影响其低血糖发生的因素。结果:两组的性别、使用胰岛素泵比例比较,差异无统计学意义(P>0.05)。A组的年龄、糖化血红蛋白(HbA1c)比例低于B组,近期确诊例数多于B组,差异有统计学意义(P<0.05)。所有患儿共行血糖监测3 887次,其中A组占2 476次,共发生162次低血糖,发生密度为6.54%(162/2 476)。在8个时段中,早饭前低血糖发生密度最高,为12.42%(37/298);其次为凌晨2:00,发生密度为9.34%(27/289);晚饭后2 h最低,发生密度仅3.31%(10/335)。经多因素logistic回归分析,患儿年龄为低血糖发生的保护因素,近期确诊为危险因素(P<0.05)。结论:T1DM患儿血糖控制效果不理想,低血糖发生率高,低龄与距确诊时间长短为T1DM患儿低血糖事件发生的高风险因素,临床应予以重点关注,根据患儿各时间段血糖波动,可对其进行预防干预措施,以降低其低血糖事件发生率。

Objective:To analyze the influencing factors of hypoglycemic events in children with type 1 diabetes mellitus(T1DM).Method:Retrospective analysis of the clinical data of 100 T1DM patients who visited Guiyang Maternal and Child Health Hospital from January 2018 to April 2022,62 cases with hypoglycemia were included in group A,while 38 cases without hypoglycemia were included in group B.The general data of the two groups were analyzed and compared,targeted blood glucose monitoring was conducted on all children during 8 time periods(before meals and 2 hours after meals,before bedtime and 2 a.m.),and logistic regression analysis was used to analyze the factors that affect the occurrence of hypoglycemia.Result:There was no statistically significant difference in gender and insulin pump usage between the two groups(P>0.05).The age,glycosylated hemoglobin(HbA1c)of group A were lower than those of group B,and recent diagnosis rate more than group B,the differences were statistically significant(P<0.05).All patients underwent blood glucose monitoring 3887 times,of which group A accounted for 2476 times,with a total of 162 occurrences of hypoglycemia and an incidence density of 6.54%(162/2476).Among the 8 time periods,the incidence density of hypoglycemia before breakfast was the highest,at 12.42%(37/298);secondly,at 2:00 a.m.,the occurrence density was 9.34%(27/289);the lowest incidence rate was 2 hours after dinner,with a density of only 3.31%(10/335).After multivariate logistic regression analysis,the age of the patient was a protective factor for the occurrence of hypoglycemia,and was recently diagnosed as a risk factor(P<0.05).Conclusion:The blood sugar control effect of T1DM children is not ideal,and the incidence of hypoglycemia is high.Low age and the length of time from diagnosis are high-risk factors for the occurrence of hypoglycemia events in T1DM children,and clinical attention should be focused on them.According to the blood sugar fluctuations of the children at different time periods,preventive interventions can be taken to reduce the probability of hypoglycemia events.