沙特阿拉伯王国阿西尔地区艾卜哈市斋月期间糖尿病患者低血糖的发生率及其危险因素
Incidence of hypoglycemia and its risk factors among diabetics during Ramadan in Abha city, Aseer Region, KSA.
作者信息
AlKhaldi Yahia Mater, AlKhaldi Ali Yahya, AlQahtani Abdullah Salman, Al-Shahrani Bushra Saeed, Meshawi Eman Abdullah, Albishri Boshra Mohammed
机构信息
Department of Research and Studies, General Directorate of Health Affairs, Aseer Region, Abha, Saudi Arabia.
Department of Academic and Internship Affairs, College of Medicine, King Khalid University, Abha, Saudi Arabia.
出版信息
J Family Med Prim Care. 2019 Sep 30;8(9):2793-2798. doi: 10.4103/jfmpc.jfmpc_250_19. eCollection 2019 Sep.
BACKGROUND AND AIMS
This study aims to explore the incidence of hypoglycemia and its risk factors among diabetic patients attending primary health care center during Ramadan Abha city, Aseer region, Saudi Arabia.
METHODS
This cross-sectional study was conducted among adult diabetic patients attending Primary health care centers (PHCCs) in Abha city, southwest of KSA. A questionnaire in Arabic language was used. It consisted of five parts that covered patients demographic and DM relevant profile, hypoglycemia attacks during Ramadan, compliance with drug, diet, exercise and glucose monitoring. Four PHCCs in Abha city were selected randomly to conduct this study. All diabetic patients who attended the selected PHCCs during the month of Shawwal 1439 (corresponding to June-July 2018) were interviewed by the investigators. Data were coded, entered and analyzed using SPSS version 22. Appropriate statistical tests were used accordingly and value was considered as significant if it was less than 5%.
RESULTS
The total patients participated in this study was 378. The mean age was 45 years, males represents 51%, mean duration of DM was 12 years, type-1DM constitutes about one third. Most of type-1 DM patients used act rapid and long acting insulin (65%), while in type-2 DM, more than one third (38%) used OHA, 8% were on insulin alone. More than half of patients (52%) reported at least one attack of hypoglycemia during Ramadan, (29%) out of them had more than four attacks. About two third of attacks (67%) occurred in the morning and evening while less than one fourth have hypoglycemia at night (17%), (2%) visited ER or PHC and 1% were admitted to hospital for further management.
CONCLUSION
This study revealed that the incidence of hypoglycemia among diabetics was high. Many Risk factors were identified; young age, type-1 DM, long duration of DM, insulin use. More attacks occurred during Ramadan day period and led to breaking the fasting among all affected patients. Most of patients were not given instructions regarding self-care immediately before or during Ramadan. Structured health education program for diabetics attending PHCC should be constructed and implemented before beginning of Ramadan in order to minimize the incidence of acute complications particularly hypoglycemia.
背景与目的
本研究旨在探究沙特阿拉伯阿西尔地区阿卜哈市在斋月期间前往初级卫生保健中心就诊的糖尿病患者中低血糖的发生率及其危险因素。
方法
本横断面研究在沙特阿拉伯西南部阿卜哈市的初级卫生保健中心（PHCCs）的成年糖尿病患者中开展。使用阿拉伯语问卷。问卷由五个部分组成，涵盖患者人口统计学信息和糖尿病相关情况、斋月期间的低血糖发作情况、药物依从性、饮食、运动及血糖监测情况。随机选择阿卜哈市的四家初级卫生保健中心开展本研究。调查人员对伊历1439年10月（对应2018年6月至7月）期间前往选定初级卫生保健中心就诊的所有糖尿病患者进行了访谈。数据使用SPSS 22版本进行编码、录入和分析。相应地使用了适当的统计检验，若p值小于5%则认为具有显著性。
结果
参与本研究的患者总数为378例。平均年龄为45岁，男性占51%，糖尿病平均病程为12年，1型糖尿病约占三分之一。大多数1型糖尿病患者使用速效和长效胰岛素（65%），而在2型糖尿病患者中，超过三分之一（38%）使用口服降糖药，8%仅使用胰岛素。超过一半的患者（52%）报告在斋月期间至少发生过一次低血糖发作，其中（29%）发作次数超过四次。约三分之二的发作（67%）发生在早晨和晚上，而夜间发生低血糖的患者不到四分之一（17%），（2%）前往急诊室或初级卫生保健中心就诊，1%因进一步治疗入院。
结论
本研究表明糖尿病患者中低血糖的发生率较高。确定了许多危险因素；年龄小、1型糖尿病、糖尿病病程长、使用胰岛素。斋月期间白天发作次数更多，导致所有受影响患者中断禁食。大多数患者在斋月前或斋月期间未得到关于自我护理的指导。应在斋月开始前为前往初级卫生保健中心就诊的糖尿病患者构建并实施结构化健康教育计划，以尽量减少急性并发症尤其是低血糖的发生率。
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