Jermendy Gyorgy, Kecskes Agnes, Nagy Attila
Bajcsy-Zsilinszky Teaching Hospital and Outpatient Clinic, 89-91 Maglodi ut, 1106 Budapest, Hungary.
77 Elektronika Kft, 98 Fehervari ut, 1116 Budapest, Hungary.
Medicina (Kaunas). 2021 Feb 14;57(2):167. doi: 10.3390/medicina57020167.
: In patients with diabetes mellitus, hypoglycaemic episodes, especially during night hours, carry a significant risk. Data about the occurrence of nocturnal hypoglycaemia in real-world settings are of clinical importance. The aim of our study was to evaluate the occurrence of nocturnal hypoglycaemia among patients with diabetes using self-monitoring of blood glucose (SMBG) with telemedicine support. : We retrospectively analysed the central database of an internet-based supportive system between 2010 and 2020 when 8190 SMBG users uploaded nearly 10 million capillary blood glucose values. Nocturnal hypoglycaemia was defined as capillary blood glucose < 3.0 mmol/L measured between 00:00 and 05:59 h. : The database contained 914,146 nocturnal blood glucose values from 7298 users; 24,623 (2.7%) glucose values were below the hypoglycaemic threshold and 2363 patients (32.4%) had at least one hypoglycaemic glucose value. Nocturnal hypoglycaemia was more often found in patients with type 1 vs. type 2 diabetes ( = 1890 (80.0%) vs. = 387 (16.4%), respectively). Hypoglycaemic blood glucose values were most frequently observed in the age group of 10.0-19.9 years ( = 481 (20.4%)). Patients with nocturnal hypoglycaemia were mostly on insulin treatment (1854 (78.5%) patients with 20,727 (84.1%) hypoglycaemic glucose values). Only 356 patients (15.1%) with nocturnal hypoglycaemia performed a retest within 120 min. Within a one-day-long (1440 min) timeframe, the elapsed median time until a retest, yielding a safe blood glucose value (>3.9 mml/L), was 273 min (interquartile range: 157-300 min). : Nocturnal hypoglycaemia should be considered as a persisting challenge to antihyperglycaemic treatment in patients living with diabetes. Continuous efforts are needed to improve both antihyperglycaemic treatment and patient education for preventing nocturnal hypoglycaemia, and to act adequately if hypoglycaemic values are detected.
在糖尿病患者中，低血糖发作，尤其是在夜间，具有重大风险。关于现实环境中夜间低血糖发生情况的数据具有临床重要性。我们研究的目的是利用远程医疗支持下的血糖自我监测（SMBG）来评估糖尿病患者中夜间低血糖的发生情况。
我们回顾性分析了一个基于互联网的支持系统的中央数据库，该数据库涵盖2010年至2020年期间，8190名血糖自我监测用户上传的近1000万条毛细血管血糖值。夜间低血糖定义为在00:00至05:59之间测得的毛细血管血糖<3.0 mmol/L。
该数据库包含来自7298名用户的914,146条夜间血糖值；24,623条（2.7%）血糖值低于低血糖阈值，2363名患者（32.4%）至少有一次低血糖血糖值。1型糖尿病患者比2型糖尿病患者更常出现夜间低血糖（分别为1890例（80.0%）和387例（16.4%））。低血糖血糖值最常出现在10.0 - 19.9岁年龄组（481例（20.4%））。夜间低血糖患者大多接受胰岛素治疗（1854例（78.5%）患者出现20,727条（84.1%）低血糖血糖值）。只有356例（15.1%）夜间低血糖患者在120分钟内进行了复测。在长达一天（1440分钟）的时间范围内，直到复测出血糖安全值（>3.9 mml/L）的中位时间为273分钟（四分位间距：157 - 300分钟）。
夜间低血糖应被视为糖尿病患者抗高血糖治疗中持续存在的挑战。需要持续努力改善抗高血糖治疗和患者教育，以预防夜间低血糖，并在检测到低血糖值时采取适当行动。
