Continuous glucose monitoring reveals hypoglycemia risk in elderly patients with type 2 diabetes mellitus.
Continuous glucose monitoring reveals hypoglycemia risk in elderly patients with type 2 diabetes mellitus.
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DOI：
10.1111/jdi.12676
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发表时间：
2018-01
影响因子：
3.2
通讯作者：
Yokote K
中科院分区：
文献类型：
--
作者：
Ishikawa T;Koshizaka M;Maezawa Y;Takemoto M;Tokuyama Y;Saito T;Yokote K
2型糖尿病在老年患者中的发病率较高，在这些患者中，这种疾病与痴呆症、跌倒、中风和死亡有关。我们利用连续血糖监测设备分析低血糖与糖尿病治疗之间的关系，以确定低血糖的危险因素(定义为血糖水平&70 mg/dL)。将接受稳态治疗的≥65岁2型糖尿病患者(其中29例住院)分为降糖组和非降糖组，比较两组患者糖化血红蛋白水平、治疗类型、动态血糖监测数据等指标。我们进行了单变量分析，以确定与低血糖风险相关的变量，然后进行了药物类别和其他因素的多变量分析。通过校准，验证了连续血糖监测数据的准确性。使用胰岛素的患者发生低血糖的风险较高(优势比[OR]2.17，95%可信区间[CI]1.16~4.08，P=0.015)，而接受二肽基肽酶-4抑制剂治疗的患者低血糖风险较低(OR0.47，95%CI：0.25~0.89，P=0.019)。血糖变异性低的患者低血糖风险显著降低(OR0.87，95%CI：0.83~0.91，P<；0.0001)，平均血糖水平较低的患者低血糖风险显著升高(OR1.09，95%CI：1.06~1.12，P<；0.0001)。在≥65岁的2型糖尿病患者中，较高的血糖变异性和较低的平均血糖水平预示着更大的低血糖风险。因此，有必要确保对这类患者进行全面的血糖控制，以预防低血糖。
The incidence of type 2 diabetes is higher in elderly patients, in whom this disease is associated with dementia, falling, stroke and death. We utilized a continuous glucose monitoring device to analyze the relationship between hypoglycemia and diabetes treatments to identify risk factors for hypoglycemia (defined as a blood glucose level <70 mg/dL). We classified 170 patients aged ≥65 years with type 2 diabetes who were receiving steady‐state medication (29 of whom were inpatients) into hypoglycemic and non‐hypoglycemic groups, and compared their glycosylated hemoglobin levels, treatment types, continuous glucose monitoring data and other parameters. We carried out univariate analyses to identify variables associated with hypoglycemia risk, followed by multivariate analyses of drug class and other factors. The accuracy of the continuous glucose monitoring data was confirmed by calibration. Hypoglycemia risk was higher in the patients using insulin (odds ratio [OR] 2.17, 95% confidence interval [CI] 1.16–4.08, P = 0.015), and lower in patients who were being treated with dipeptidyl peptidase‐4 inhibitors (OR 0.47, 95% CI: 0.25–0.89, P = 0.019). Patients with lower variability in blood glucose had a significantly lower hypoglycemia risk (OR 0.87, 95% CI: 0.83–0.91, P < 0.0001), and those with a lower average blood glucose level had a significantly higher risk (OR 1.09, 95% CI: 1.06–1.12, P < 0.0001). In patients aged ≥65 years with type 2 diabetes, higher glucose variability and lower average glucose levels indicate a greater hypoglycemia risk. It is therefore necessary to ensure comprehensive blood glucose control in such patients to prevent hypoglycemia.
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影响因子：
11.1
作者：
Lin, C. -H.;Sheu, W. H. -H.
通讯作者：
Sheu, W. H. -H.
影响因子：
16.2
作者：
Rizzo MR;Barbieri M;Marfella R;Paolisso G
通讯作者：
Paolisso G
影响因子：
158.5
作者：
Gerstein, Hertzel C.;Miller, Michael E.;Friedewald, William T.
通讯作者：
Friedewald, William T.
影响因子：
5.1
作者：
OHKUBO, Y;KISHIKAWA, H;SHICHIRI, M
通讯作者：
SHICHIRI, M
影响因子：
5
作者：
Gehlaut, Richa Redhu;Dogbey, Godwin Y;Shubrook, Jay H
通讯作者：
Shubrook, Jay H