Department of Internal Medicine, Ohio State University, Columbus, Ohio.
Division of Endocrinology, Diabetes and Metabolism, Ohio State University, Columbus, Ohio.
Diabetes Obes Metab. 2018 Oct;20(10):2472-2476. doi: 10.1111/dom.13376. Epub 2018 Jun 15.
Hospitalized patients with heart failure (HF) undergoing bedside glucose monitoring with subcutaneous insulin orders were retrospectively identified over 2 years. Hypoglycaemia was defined as any glucose value <3.9 mmol/L (70 mg/dL) within 24 hours of admission (Hypo ) or throughout the hospitalization (Hypo ) or any glucose value <2.2 mmol/L (40 mg/dL) throughout the hospitalization (Hypo ). A total of 13 424 patients were included, of whom 2484 had HF. Patients with HF were more likely to have Hypo (9.1% vs 7.0%, P = .0003), Hypo (28% vs 18.5%, P < .0001), or Hypo (3.4% vs 2.1%, P = .0001). After controlling for other variables, the odds of Hypo were similar between the HF and non-HF groups (odds ratio [OR] 1.14, 95% CI 0.94-1.39, P = .18, fully adjusted model), slightly lower for Hypo (OR 0.85, 95% CI 0.73-0.99, P = .03, fully adjusted model), and similar for Hypo (OR 1.25, 95% CI 0.91-1.70, P = .17). Hypo , Hypo and Hypo were all associated with increased mortality; there was no evidence of an interaction by HF status. Hypoglycaemia occurred at a similar or lower frequency in hospitalized patients with HF compared to those without HF. Hypoglycaemia was associated with increased hospital mortality, regardless of HF status.
在过去的两年中,对因心力衰竭(HF)而需要接受皮下胰岛素医嘱并进行床边血糖监测的住院患者进行了回顾性研究。低血糖定义为入院后 24 小时内任何血糖值<3.9 mmol/L(70mg/dL)(Hypo)或整个住院期间(Hypo)或整个住院期间任何血糖值<2.2mmol/L(40mg/dL)(Hypo)。共纳入 13424 例患者,其中 2484 例患有 HF。HF 患者发生 Hypo 的可能性更高(9.1%比 7.0%,P=0.0003)、Hypo(28%比 18.5%,P<0.0001)或 Hypo(3.4%比 2.1%,P=0.0001)的可能性更高。在控制其他变量后,HF 组与非 HF 组发生 Hypo 的可能性相似(比值比[OR]为 1.14,95%CI 为 0.94-1.39,P=0.18,完全调整模型),发生 Hypo 的可能性略低(OR 为 0.85,95%CI 为 0.73-0.99,P=0.03,完全调整模型),发生 Hypo 的可能性相似(OR 为 1.25,95%CI 为 0.91-1.70,P=0.17)。Hypo、Hypo 和 Hypo 均与死亡率增加相关;HF 状态无交互作用的证据。与无 HF 的住院患者相比,HF 住院患者发生低血糖的频率相似或更低。低血糖与住院死亡率增加相关,无论 HF 状态如何。