Impact of improved glycaemic control on rates of hypoglycaemia in insulin dependent diabetes mellitus
Impact of improved glycaemic control on rates of hypoglycaemia in insulin dependent diabetes mellitus
复制标题
DOI：
10.1136/adc.78.2.111
复制
发表时间：
1998-02-01
影响因子：
5.2
通讯作者：
Jones, TW
中科院分区：
文献类型：
--
作者：
Davis, EA;Keating, B;Jones, TW
加强对胰岛素依赖型糖尿病（IDDM）的严格血糖控制可能会导致严重低血糖的发生率增加。为了评估这种情况是否适用于以人口为基础的IDDM儿童和青少年的严重（昏迷、惊厥）和中度（需要辅助治疗）低血糖的发生率，我们前瞻性地研究了四年时间。共研究了709例患者，获得了2027例患者年的数据(平均（SD）年龄：12.3 (4.4)；范围0-18年，持续时间IDDM: 4.9（3.8）年。每三个月就诊一次记录低血糖的详细情况，同时测量糖化血红蛋白（HbA1(c)）。总体而言，重度低血糖的发生率为7.8次/100患者年，中度低血糖的发生率为15.4次/100患者年。四年来，平均（SD）临床HbA1(c)从1992年的10.2%(1.6)%稳步下降到1995年的8.8(1.5)%。与此同时，低血糖发生率急剧增加，特别是在研究的第四年，严重低血糖从4.8次/100患者年增加到15.6次/100患者年。这种增长在年幼的儿童中尤为明显(
Increased emphasis on strict glycaemic control of insulin dependent diabetes mellitus (IDDM) in young patients may be expected to cause increases in rates of significant hypoglycaemia. To evaluate whether this is the case for a large population based sample of IDDM children and adolescents rates of severe (coma, convulsion) and moderate (requiring assistance for treatment) hypoglycaemia were studied prospectively over a four year period.A total of 709 patients were studied yielding 2027 patient years of data (mean (SD) age: 12.3 (4.4); range 0-18 years, duration IDDM: 4.9 (3.8) years). Details of hypoglycaemia were recorded at clinic visits every three months when glycated haemoglobin (HbA1(c)) was also measured.Overall the incidence of severe hypoglycaemia was 7.8 and moderate was 15.4 episodes/100 patient years. Over the four years mean (SD) clinic HbA1(c) steadily fell from 10.2 (1.6)% in 1992 to 8.8 (1.5)% in 1995. In parallel with this there was a dramatic increase in the rate of hypoglycaemia, especially in the fourth year of the study, when severe hypoglycaemia increased from 4.8 to 15.6 episodes/100 patient years. This increase was particularly marked in younger children (