Analysis of risk factors for severe hypoglycemia in type 2 diabetes mellitus
10.3760/cma.j.issn.0254-9026.2013.12.008
- VernacularTitle:2型糖尿病患者发生严重低血糖事件危险因素分析
- Author:
Ping ZHU
;
Jianmin RAN
;
Gancheng LAO
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus,type 2;
Hypoglycemia;
Risk factors
- From:
Chinese Journal of Geriatrics
2013;32(12):1289-1293
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for severe hypoglycemia in the treatment of type 2 diabetes mellitus (T2DM) and to provide scientific rationales for the prevention of hypoglycemia in treating diabetes.Methods Clinical data of 49 T2DM patients with severe hypoglycemia (hypoglycemic group) and 98 T2DM patients without hypoglycemia as control group were retrospectively analyzed.Severe hypoglycemia was defined as that patient requiring assistance for intaking carbohydrate to alleviate hypoglycemia and plasma glucose concentration was less than 3.9 mmol/L.Clinical and biochemical indexes were analyzed by the single-factor analysis.Logistic regression model was established by multi factors regression analysis,and the receiver operating characteristic (ROC) curve was used to assess the performance of the logistic regression model.Results The mean serum glucose level was (2.3±0.7) mmol/L during hypoglycemia in hypoglycemia group.The mean age was higher in hypoglycemia group than in control group [(76.2±6,5) years vs.(69.8±11.5) years,P=0.001].The mean glycosylated hemoglobin Alc (HbAlc) level was lower in hypoglycemia group than in control group [(6.4±0.8)％ vs.(9.1± 2.5)％,P＜0.001].Endogenous creatinine clearance rate (Ccr) was lower in hypoglycemia group than in control group [(46.8±21.0) ml/min vs.(74.2 ± 24.5) ml/min,P＜0.001].Logistic regression analysis indicated that female and HbA1c level were the independent risk factors for severe hypoglycemia (OR=11.83,0.91 and 0.18,95％CI:1.82 76.93,0.86-0.97 and 0.08-0.44,respectiely] ; T2DM therapies with insulin and insulin secretagogues increased the risk of hypoglycemia (OR＝12.31 and 5.36,95％CI:1.70-88.88 and 1.08-26.56); however,duration of diabetes,body mass index (BMI),and urinary microalbumin (UMA) had no correlation with severe hypoglycemia (all P＞0.05).The area under the ROC curve was 96.5％ by the logistic regression model.Conclusions Gender,Ccr,HbA1c,insulin and insulin secretagogues are the main risk factors for severe hypoglycemia in T2DM patients.Preventive interventions of hypoglycemia should be taken earlier for the patients with the high risk factors.
