Blood glucose fluctuation and risk factors in type 2 diabetic patients with asymptomatic hypoglycemia
10.3760/cma.j.cn311282-20220606-00357
- VernacularTitle:无症状低血糖2型糖尿病患者血糖波动特点及危险因素分析
- Author:
Yonghong CAO
1
;
Xudong YAO
;
Erlan SHI
;
Suwan ZHANG
;
Shimei XING
;
Shuai YE
;
Xinjie SONG
;
Rong ZHANG
;
Zhenzhen WANG
;
Wu DAI
Author Information
1. 安徽医科大学附属合肥医院（合肥市第二人民医院）内分泌科，合肥 230011
- Keywords:
Diabetes mellitus, type 2;
Asymptomatic hypoglycemia;
Blood glucose fluctuation;
Mean amplitude of glycemic excursions
- From:
Chinese Journal of Endocrinology and Metabolism
2022;38(12):1052-1056
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the characteristics of blood glucose fluctuation and risk factors in type 2 diabetic patients with asymptomatic hypoglycemia.Methods:From September 2018 to July 2021, 342 patients with type 2 diabete mellitus who were hospitalized in the Department of Endocrinology of Hefei Hospital Affilitated to Anhui Medical University were enrolled for a retrospective study. The mean amplitude of glycemic excursions(MAGE), coefficient of variation (CV), 24 hour mean blood glucose level (MG), and time in range (TIR) were obtained by continuous glucose monitoring (CGM). According to the results of CGM and whether the patients have hypoglycemia symptoms, they were divided into three groups: no hypoglycemia group, symptomatic hypoglycemia group, and asymptomatic hypoglycemia group. The differences in blood glucose fluctuations were compared among the three groups. Multivariate logistic regression analysis was used to evaluate the risk factors in type 2 diabete mellitus patients with asymptomatic hypoglycemia. The predictive value of MAGE for asymptomatic hypoglycemia was analyzed by receiver operating characteristic (ROC) curve.Results:Compared with the non-hypoglycemia group, the TIR in asymptomatic hypoglycemia group was higher ( Z=-2.042, P=0.041). The asymptomatic hypoglycemia group had lower MG, higher MAGE and CV compared with the other two groups(all P<0.05). Multivariate logistic regression analysis showed that urinary albumin/creatinine ratio (UACR), MAGE, and CV were the risk factors for asymptomatic hypoglycemia, while MG was the protective factor. After adjustment for other risk factors, MAGE was still associated with asymptomatic hypoglycemia ( OR=1.111, 95% CI 0.999-1.235, P=0.049). The sensitivity and specificity of MAGE in predicting asymptomatic hypoglycemia were 0.769 and 0.776, respectively. Conclusions:Patients with asymptomatic hypoglycemia present with larger TIR and MAGE. MAGE, UACR, and CV were risk factors for asymptomatic hypoglycemia. Moreover, MAGE has some predictive value for the occurrence of asymptomatic hypoglycemia.
