Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Calo Psychiatric Center, Pingtung County, Taiwan.
Department of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan.
J Diabetes Complications. 2019 Feb;33(2):123-127. doi: 10.1016/j.jdiacomp.2018.10.014. Epub 2018 Oct 25.
This study investigated the effect of severe hyperglycemia episodes on survival and associated factors related to risk of mortality in type 2 diabetes mellitus (DM) patients with dementia.
We enrolled all type 2 DM patients newly diagnosed as having dementia in Taiwan from 1998 to 2005. These patients were categorized into those who had hyperglycemia episodes and those who did not based on whether or not they had been hospitalized for hyperglycemia after dementia diagnosis. Factors independently associated with mortality were evaluated.
Of 5314 patients identified, 303 (5.7%) had at least one hyperglycemia hospitalization. Patients with at least one hyperglycemia hospitalization had a 30% greater risk of mortality than those who had no such admissions (adjusted hazard ratio: 1.30, 95% confidence interval: 1.09-1.55). Other variables, including age, sex, geographical region, insurance amount, patient with congestive heart failure, cerebrovascular disease, renal disease, use of anti-hypertensive drugs, use of anti-lipid drugs, and use of insulin were independently associated with risk of mortality.
Severe hyperglycemia is common in type 2 DM patients with dementia and it substantially shortens their life. The findings of this study suggest a great need to improve care in DM patients with dementia.
本研究旨在探讨严重高血糖事件对 2 型糖尿病（DM）合并痴呆患者生存的影响及其与死亡率相关的危险因素。
我们纳入了 1998 年至 2005 年在台湾新诊断为痴呆的所有 2 型 DM 患者。根据痴呆诊断后是否因高血糖住院，将这些患者分为发生高血糖事件组和未发生高血糖事件组。评估与死亡率独立相关的因素。
在确定的 5314 例患者中，有 303 例（5.7%）至少发生过一次高血糖住院。与未发生此类住院的患者相比，至少发生过一次高血糖住院的患者死亡风险增加 30%（校正后的危险比：1.30，95%置信区间：1.09-1.55）。其他变量，包括年龄、性别、地理位置、保险金额、充血性心力衰竭、脑血管疾病、肾脏疾病、抗高血压药物使用、抗血脂药物使用和胰岛素使用与死亡率独立相关。
严重高血糖在 2 型 DM 合并痴呆患者中很常见，严重缩短了他们的寿命。本研究的结果表明，迫切需要改善 DM 合并痴呆患者的护理。
