老年糖尿病患者低血糖危险因素的Meta分析

Meta-analysis of risk factors for hypoglycemia in elderly patients with diabetes mellitus

目的系统评价老年糖尿病患者发生低血糖的危险因素。方法检索PubMed、Embase、Web of Science、Cochrane Library、中国知网、万方数据库中关于老年糖尿病患者低血糖危险因素的相关研究,检索时限为建库至2023年7月15日。由2名研究者独立进行文献筛选、资料提取以及质量评价,并采用Stata 15.1软件进行数据处理。结果共纳入20篇文献,涉及研究对象656293例。Meta分析结果显示:年龄≥80岁、体质指数<25 kg/m^(2)、使用胰岛素、磺脲类药物、联合使用降糖药、病程>10年、未行自我血糖监测、肾功能受损、痴呆或认知功能障碍是老年糖尿病患者发生低血糖的危险因素。结论老年糖尿病患者发生低血糖受较多危险因素影响,护理人员应针对这些危险因素进行早期筛查和干预,降低老年糖尿病患者低血糖的发生率。

Objective To identify the risk factors for hypoglycemia in elderly patients with diabetes mellitus.Methods Studies on risk factors for hypoglycemia in elderly patients with diabetes mellitus were searched in databases such as PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang Database,with the search time up to July 15,2023.Two independent researchers conducted literature screening,data extraction and quality evaluation,followed by the data processing using the Stata 15.1 software.Results A total of 20 studies were included,covering 656293 subjects.According to the Meta-analysis,age≥80 years,BMI<25 kg/m^(2),insulin,sulfonylureas,combined use of hypoglycemic drugs,disease duration>10 years,no self-monitor blood glucose,impaired renal function,dementia or cognitive dysfunction were risk factors for hypoglycemia in elderly patients with diabetes mellitus.Conclusion Many factors can result in hypoglycemia in elderly patients with diabetes mellitus.Therefore,nursing staff should carry out early screening and intervention to lower its occurrence.