Pilemann-Lyberg S, Thorsteinsson B, Snorgaard O, Zander M, Vestergaard H, Røder M E
Center for Diabetes Research, Department of Medicine, Gentofte Hospital, Denmark; Steno Diabetes Center, Denmark.
Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital Hillerød, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
Diabetes Res Clin Pract. 2015 Nov;110(2):202-7. doi: 10.1016/j.diabres.2015.09.006. Epub 2015 Oct 26.
Sulphonylureas (SU) are currently recommended as a well-established second line treatment in guidelines for type 2 diabetes (T2DM). In the Capital Region of Denmark 16,865 patients were given SU as part of their treatment of T2DM in 2010-2011. To what extent SU are associated with hospitalizations due to severe hypoglycaemic episodes, defined as episodes with a need for external assistance, was investigated. The prevalence and characteristics of these patients and potential risk factors were studied.
ICD-10 diagnosis codes were used to identify patients hospitalized due to hypoglycaemia and T2DM for a period of 2 years (2010-2011). Inclusion criteria were T2DM, hospitalization due to hypoglycaemia and treatment with SU as monotherapy or in combination with other glucose-lowering drugs except insulin treatment.
We identified 161 patients fulfilling the inclusion criteria. Their mean age was 76 (53-97) years and 54% were males. Sixty percent of the patients had diabetic complications, including 19% with diabetic nephropathy. The major reason for severe hypoglycaemia was an unchanged dose of SU despite of a significant decline in food intake (45%). In 22% of the patients more than one reason was listed, most commonly a concomitant infection associated with decreased food intake and unchanged dose of SU.
The incidence of hospital admission-requiring severe hypoglycaemia in patients treated with SU was 0.48 episodes per 100 patient-years of SU-treated patients. It was mainly older patients with diminished food intake, excessive alcohol use or other medications, concomitant infection, and with diabetic complications.
磺脲类药物（SU）目前在2型糖尿病（T2DM）指南中被推荐为一种成熟的二线治疗药物。在丹麦首都地区，2010 - 2011年期间有16865名患者接受SU作为其T2DM治疗的一部分。研究了SU与因严重低血糖发作（定义为需要外部协助的发作）导致住院的关联程度。对这些患者的患病率、特征及潜在风险因素进行了研究。
使用国际疾病分类第十版（ICD - 10）诊断编码来识别在2年期间（2010 - 2011年）因低血糖和T2DM住院的患者。纳入标准为T2DM、因低血糖住院且接受SU单药治疗或与除胰岛素治疗外的其他降糖药物联合治疗。
我们确定了161名符合纳入标准的患者。他们的平均年龄为76岁（53 - 97岁），54%为男性。60%的患者有糖尿病并发症，其中19%有糖尿病肾病。严重低血糖的主要原因是尽管食物摄入量显著下降，但SU剂量未改变（45%）。22%的患者列出了不止一个原因，最常见的是与食物摄入量减少和SU剂量不变相关的合并感染。
接受SU治疗的患者中，因严重低血糖需要住院治疗的发生率为每100患者 - 年SU治疗0.48次发作。主要是老年患者，存在食物摄入量减少、过度饮酒或使用其他药物、合并感染以及有糖尿病并发症。
