李旭, 袁济钢, 罗章英, 王燕, 徐辉, 沈志萍, 李觉, 张丽娟. 社区2型糖尿病患者低血糖发生风险的病例对照研究[J]. 上海预防医学, 2022, 34(4): 366-370. DOI: 10.19428/j.cnki.sjpm.2022.21153
引用本文: 李旭, 袁济钢, 罗章英, 王燕, 徐辉, 沈志萍, 李觉, 张丽娟. 社区2型糖尿病患者低血糖发生风险的病例对照研究[J]. 上海预防医学, 2022, 34(4): 366-370. DOI: 10.19428/j.cnki.sjpm.2022.21153
LI Xu, YUAN Jigang, LUO Zhangying, WANG Yan, XU Hui, SHEN Zhiping, LI Jue, ZHANG Lijuan. Risk factors associated with hypoglycemia in patients with type 2 diabetes mellitus: a community based case-control study[J]. Shanghai Journal of Preventive Medicine, 2022, 34(4): 366-370. DOI: 10.19428/j.cnki.sjpm.2022.21153
Citation: LI Xu, YUAN Jigang, LUO Zhangying, WANG Yan, XU Hui, SHEN Zhiping, LI Jue, ZHANG Lijuan. Risk factors associated with hypoglycemia in patients with type 2 diabetes mellitus: a community based case-control study[J]. Shanghai Journal of Preventive Medicine, 2022, 34(4): 366-370. DOI: 10.19428/j.cnki.sjpm.2022.21153

社区2型糖尿病患者低血糖发生风险的病例对照研究

Risk factors associated with hypoglycemia in patients with type 2 diabetes mellitus: a community based case-control study

  • 摘要:
    目的 探究社区2型糖尿病患者低血糖发生的危险因素,为减少2型糖尿病低血糖的发生提供依据。
    方法 以2018年在同济大学医学院附属安亭镇社区卫生服务中心糖尿病小屋建档、既往无低血糖病史的2型糖尿病患者914例为研究对象,其中纳入研究后1年内发生低血糖≥1次的糖尿病患者196例为病例组,同期未发生低血糖事件的718例患者为对照组,进行病例对照研究,调查2组患者的基本情况、疾病史、用药情况、生活习惯及相关危险因素等。采用多因素logistic回归分析糖尿病患者发生低血糖的危险因素。
    结果 多因素回归分析显示,冠心病史[标化比值比(aOR)=2.077,95%CI:1.293~3.337)]、肾脏病史(aOR=4.775,95%CI:1.537~14.830)及胰岛素使用史(aOR=1.765,95%CI:1.147~2.716)是低血糖发生的危险因素,使用血管紧张素转化酶抑制剂(ACEI)(aOR=0.127,95%CI:0.044~0.366)及β⁃受体阻滞剂(aOR=0.271,95%CI:0.119~0.616)则为糖尿病患者发生低血糖的保护因素。
    结论 社区2型糖尿病患者存在一定比例的低血糖发生风险。既往冠心病史、肾脏病史及胰岛素的使用是患者低血糖发生风险升高的独立危险因素,社区全科医生应给予更多关注。

     

    Abstract:
    Objective To determine the risk factors associated with hypoglycemia in community patients with type 2 diabetes mellitus(T2DM).
    Methods A case-control study was performed among 914 patients with T2DM and no medical history of hypoglycemia were selected in the Diabetes Unit of Tongji University School of Medicine Affiliated Anting Community Health Center in 2018. A total of 196 patients with T2DM who had ≥1 hypoglycemia event in the past 12 months were presented as the case group, and 718 patients who did not have any hypoglycemia event during the same period were included as the control group. Medical history, medication, life style, and related factors were collected. Multivariate logistic regression analysis was used to determine the risk factors associated with hypoglycemia.
    Results History of coronary heart disease [adjusted odds ratio(aOR)=2.077, 95% CI: 1.293-3.337], renal disease (aOR=4.775, 95% CI: 1.537-14.830), and previous insulin use (aOR =1.765, 95%CI: 1.147-2.716) significantly increased the risk of hypoglycemia, while angiotensin converting enzyme inhibitors(ACEI)(aOR =0.127, 95%CI: 0.044-0.366) and β-receptor blockers (aOR =0.271, 95%CI: 0.119-0.616) decreased the risk of hypoglycemia among diabetic patients.
    Conclusion Incidence of hypoglycemia in community patients with diabetes is high. History of coronary heart disease and kidney disease, and previous insulin use may increase the risk of hypoglycemia, which warrants further attention by community general practitioners.

     

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