Braatvedt Geoffrey D, Sykes Adrian J, Panossian Zaven, McNeill Dianna
1 Department of Medicine, University of Auckland , Auckland, New Zealand .
Diabetes Technol Ther. 2014 Oct;16(10):661-6. doi: 10.1089/dia.2014.0024. Epub 2014 Jul 10.
This study describes the clinical course of adult patients with type 2 diabetes taking a sulfonylurea and presenting to the hospital with severe hypoglycemia.
This was a retrospective chart review of all patients >15 years of age with type 2 diabetes and taking a sulfonylurea who presented to the emergency services of Auckland City Hospital over a 6-year period with severe hypoglycemia.
One hundred eighty-five patients met the inclusion criteria. Their mean ± SD age was 71 ± 11 years, and known duration of diabetes was 14.7 ± 10 years. Of the patients, 167 had micro- and/or macrovascular complications of diabetes, and one-third had had a previous admission with hypoglycemia. Only 61 patients (33%) had a glomerular filtration rate of >60 mL/min. The length of stay was not correlated with admission creatinine level (highest tertile of creatinine, 71 ± 93 h; lowest tertile, 51 ± 79 h). Recurrent in-hospital hypoglycemia occurred in over one-third of patients, and 28 (15%) were re-admitted to the hospital within 28 days of discharge for various reasons, including further hypoglycemia in 13 patients. Two patients died during their admission.
Patients with type 2 diabetes presenting to the hospital with sulfonylurea-associated hypoglycemia have a high burden of comorbidity, require a long hospital stay, and are at risk of subsequent re-admission to hospital. Careful evaluation of their best future treatment strategies must be undertaken taking account of their comorbidities, including their renal function.
本研究描述了服用磺脲类药物并因严重低血糖症入院的成年2型糖尿病患者的临床病程。
这是一项对所有年龄大于15岁、患有2型糖尿病且服用磺脲类药物、在6年期间因严重低血糖症到奥克兰市医院急诊就诊的患者进行的回顾性病历审查。
185例患者符合纳入标准。他们的平均年龄±标准差为71±11岁，已知糖尿病病程为14.7±10年。其中，167例患者患有糖尿病微血管和/或大血管并发症，三分之一的患者曾因低血糖症入院。只有61例患者（33%）的肾小球滤过率>60 mL/分钟。住院时间与入院时肌酐水平无关（肌酐最高三分位数组，71±93小时；最低三分位数组，51±79小时）。超过三分之一的患者在住院期间发生复发性低血糖症，28例（15%）患者在出院后28天内因各种原因再次入院，其中13例患者是因再次发生低血糖症。两名患者在住院期间死亡。
因磺脲类药物相关低血糖症入院的2型糖尿病患者合并症负担重，住院时间长，且有随后再次入院的风险。必须根据他们的合并症，包括肾功能，仔细评估他们未来最佳的治疗策略。
