Department of Outpatient, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China.
Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China.
Afr Health Sci. 2023 Jun;23(2):499-508. doi: 10.4314/ahs.v23i2.58.
To explore the risk factors for hypoglycemia in patients with type 2 diabetes mellitus (T2DM) after intensive insulin therapy and the blood glucose monitoring strategy.
A total of 172 T2DM patients diagnosed from March 2019 to March 2021 were randomly divided into training (n=115) and test sets (n=57), and given intensive insulin therapy. After treatment, the training set was divided into hypoglycemia (n=35) and non-hypoglycemia groups (n=80). Univariate and multivariate logistic regression analyses were performed. Then 120 patients were divided into instantaneous scanning glucose test system monitoring (observation) and glucometer monitoring (control) groups. The diagnostic values of the two methods were validated using receiver operator characteristic curves.
Course of disease, body mass index, fasting C-peptide and creatinine were independent risk factors for hypoglycemia, while instantaneous scanning glucose test system monitoring and glucometer monitoring were protective factors (P<0.05). The model had high predictive value. The observation group had shorter time of blood glucose reaching the standard, smaller insulin dose, and lower risk of hypoglycemia than those of the control group (P<0.05).
During intensive insulin therapy by multiple subcutaneous injections, the clinical effect of instantaneous scanning glucose test system on T2DM patients is better than that of glucometer.
探讨 2 型糖尿病（T2DM）患者强化胰岛素治疗后发生低血糖的危险因素及血糖监测策略。
选取 2019 年 3 月至 2021 年 3 月本院收治的 172 例 T2DM 患者，随机分为训练集（n=115）和测试集（n=57），均给予强化胰岛素治疗。治疗后，将训练集分为低血糖组（n=35）和非低血糖组（n=80）。对单因素和多因素逻辑回归分析。然后将 120 例患者分为瞬感血糖监测系统监测组（观察组）和血糖仪监测组（对照组），采用受试者工作特征曲线验证两种方法的诊断价值。
病程、体质量指数、空腹 C 肽和肌酐是低血糖的独立危险因素，瞬感血糖监测系统监测和血糖仪监测是保护因素（P<0.05）。该模型具有较高的预测价值。观察组血糖达标时间、胰岛素用量均短于对照组，低血糖风险低于对照组（P<0.05）。
在多次皮下注射强化胰岛素治疗时，瞬感血糖监测系统对 T2DM 患者的临床效果优于血糖仪。
