Kant Ravi, Yadav Poonam, Pratti Madhuri, Barnwal Shruti
Department of Medicine, All India Institute of Medical Sciences, Rishikesh, India.
Center of Excellence in Nursing Education and Research, All India Institute of Medical Sciences, Rishikesh, India.
Caspian J Intern Med. 2022 Winter;13(1):29-37. doi: 10.22088/cjim.13.1.29.
Hypoglycemia is frequently associated with insulin therapy in diabetic patients; it leads to many short and long-term complications and even death if not addressed in time. This study was undertaken to observe the circadian propensity of hypoglycemia and its recovery time based on type 2 diabetes mellitus patients' clinical parameters.
We included type 2 diabetes mellitus (DM) hospitalized patients with the exclusion of patients suffering from critical illness. Data were collected for a period of three months (September to November 2019).
A total of 120 patients were included, comprising 60% males and 40% females. Approximately 55% of patients had hypoglycemic episodes at around 12 am- 6 am. The most common comorbidity present in these patients was hypertension (43.3%, P=0.931). Anemia (OR-3.765, CI-1.350-5.500, P=0.011), retinopathy (OR 6.066, CI-2.031-8.113, P=0.001), and duration of DM (OR-6.266, CI-2.209-7.774, P=0.001) were significantly associated with the recovery time of hypoglycemia, around 50±14.14min in the elderly population of age 60-70. People with BMI 22.5- 27.5 Kg/m took around 45.66 ± 19.37 min to recover after treatment.
Time taken to recover from hypoglycemic episodes vary with age and BMI Associated comorbidities such as anemia, retinopathy, and DM duration had a significant bearing on the time taken to recover from hypoglycemia. Recovery time was directly proportional to BMI, a new finding that needs further molecular level evaluation. Circadian propensity of hypoglycemia in these patients have been identified in the early morning hours of the day.
低血糖在糖尿病患者中常与胰岛素治疗相关；若不及时处理，会导致许多短期和长期并发症甚至死亡。本研究旨在基于2型糖尿病患者的临床参数观察低血糖的昼夜倾向及其恢复时间。
我们纳入了2型糖尿病住院患者，排除患有危重症的患者。收集了为期三个月（2019年9月至11月）的数据。
共纳入120例患者，其中男性占60%，女性占40%。约55%的患者在凌晨12点至6点左右出现低血糖发作。这些患者中最常见的合并症是高血压（43.3%，P = 0.931）。贫血（OR = 3.765，CI = 1.350 - 5.500，P = 0.011）、视网膜病变（OR = 6.066，CI = 2.031 - 8.113，P = 0.001）和糖尿病病程（OR = 6.266，CI = 2.209 - 7.�74，P = 0.001）与低血糖的恢复时间显著相关，在60 - 70岁的老年人群中恢复时间约为50±14.14分钟。体重指数（BMI）为22.5 - 27.5 Kg/m²的患者治疗后恢复时间约为45.66±19.37分钟。
低血糖发作后的恢复时间因年龄和BMI而异。贫血、视网膜病变和糖尿病病程等相关合并症对低血糖恢复时间有显著影响。恢复时间与BMI成正比，这一新发现需要进一步在分子水平进行评估。已确定这些患者低血糖的昼夜倾向在一天中的清晨时段。
