Alghamdi Erada M, Alghubayshi Laila A, Alshamrani Reem A, Alnajashi Rawan A, Alamoudi Ebtihal A, Aljabarti Amani M, Zarif Hawazen A
Internal Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah Medical Research Center, Ministry of the National Guard, Jeddah, SAU.
Internal Medicine, King Abdulaziz University, Jeddah, SAU.
Cureus. 2020 Jan 22;12(1):e6742. doi: 10.7759/cureus.6742.
Background Hypoglycemia is a pathological condition in which the serum glucose level measures less than 3.0 mmol/L. It is a well-known complication in patients with diabetes mellitus. Age, body weight, gender, insulin usage, nutritional therapy, body mass index (BMI), the presence of diabetes complications, intensive care unit admission, and infection were reported as possible risk factors that may increase the risk of hypoglycemia. Therefore, this study aimed to analyze predisposing factors for hypoglycemia among hospitalized patients with type 2 diabetes in King Abdulaziz Medical City. Method This is a retrospective, case-control study design. The study included 326 hospitalized patients with type 2 diabetes; 152 experienced hypoglycemia (blood glucose <3.9) at least once during hospitalization and have been compared to 174 in the non-hypoglycemic group (blood glucose ≥3.9). Data were extracted from their electronic medical records (EMRs). Results This study reported that patients with lower BMI (28.80 ± 7 versus 31.20 ± 12.93) experienced hypoglycemia (P-value 0.044). Those hospitalized with infections or had acquired infections or required intensive care unit (ICU) admission during hospitalization had a higher risk to develop hypoglycemia (P-value 0.005, 0.003, and <0.001, respectively). Moreover, the use of multiple doses of insulin therapy or basal-plus insulin therapy was associated with a higher risk of hypoglycemia (P-value 0.012 and 0.028, respectively). Those on supplemental insulin were less likely to develop hypoglycemia (P-value <0.001). Patients on oral feeding had a lower chance of having a hypoglycemic attack (P-value 0.002) while those on tube feeding had double the odds (OR=2.37). Conclusions Infection, intensive care unit admission, lower body mass index, insulin regimen and nutritional therapy (enteral feeding and nothing-per-mouth (NPO)) were correlated with an elevated risk of having hypoglycemia in hospitalized patients with type 2 diabetes mellitus.
低血糖是一种血清葡萄糖水平低于3.0 mmol/L的病理状态。它是糖尿病患者中一种众所周知的并发症。年龄、体重、性别、胰岛素使用情况、营养治疗、体重指数（BMI）、糖尿病并发症的存在、入住重症监护病房以及感染被报道为可能增加低血糖风险的危险因素。因此，本研究旨在分析阿卜杜勒阿齐兹国王医疗城住院的2型糖尿病患者发生低血糖的易感因素。
这是一项回顾性病例对照研究设计。该研究纳入了326例住院的2型糖尿病患者；其中152例在住院期间至少经历过一次低血糖（血糖<3.9），并与174例非低血糖组（血糖≥3.9）患者进行了比较。数据从他们的电子病历（EMR）中提取。
本研究报告称，BMI较低的患者（28.80±7对比31.20±12.93）发生低血糖（P值0.044）。那些在住院期间感染或获得感染或需要入住重症监护病房（ICU）的患者发生低血糖的风险更高（P值分别为0.005、0.003和<0.001）。此外，使用多剂量胰岛素治疗或基础加餐时胰岛素治疗与更高的低血糖风险相关（P值分别为0.012和0.028）。使用补充胰岛素的患者发生低血糖的可能性较小（P值<0.001）。经口进食的患者发生低血糖发作的几率较低（P值0.002），而鼻饲患者的几率则翻倍（OR=2.37）。
感染、入住重症监护病房、较低的体重指数、胰岛素治疗方案和营养治疗（肠内营养和禁食）与住院2型糖尿病患者发生低血糖的风险升高相关。
