Awasthi Rajiv, Pande Arun K, Chandra Kumar P, Agarwal Vivek, Gupta Mukulesh, Tewari Ajoy, Gupta Nitin, Chaubey Santosh, Chaudhary Sandeep, Ansari Sajid, Kumar Dinesh
Internal Medicine, Prarthana Clinic and Diabetes Care Centre, Lucknow, Uttar Pradesh, India.
Endocrinology, Lucknow Endocrine Diabetes and Thyroid Clinic, Lucknow, Uttar Pradesh, India.
Indian J Endocrinol Metab. 2024 Jan-Feb;28(1):86-90. doi: 10.4103/ijem.ijem_42_23. Epub 2024 Feb 26.
The study was aimed at identifying the incidence of unreported probable hypoglycaemia in individuals with type 2 diabetes (T2DM) on anti-diabetic medications, using the screening Stanford Hypoglycemia Questionnaire (SHQ) in real-world situations.
It was a multicentre cross-sectional study on consecutive individuals attending 10 diabetes care centres in Lucknow, Uttar Pradesh, India. The inclusion criteria were as follows: known individuals with T2DM, literate, age greater than or equal to 18 years, on at least one anti-diabetic agent for more than a month and not engaged in regular self-monitoring of blood glucose (SMBG).
This study was conducted from August 2017 to April 2018, involving 1198 participants. The mean age of the individuals enrolled was 53.45 years (±10.83), with males comprising 55.3% of the population. It was found that 63.6% of patients were on sulphonylurea (SU), 14.5% were on pioglitazone, 92.2% on metformin, 62.3% on Dipeptidyl peptidase (DPP4i) and 12.8% on Sodium-glucose cotransporter (SGLT2i). The mean SHQ score was 1.81 (±1.59). Probable hypoglycaemia was mild in 57.59%, moderate in 14.69% and severe in 1.41%. Those with diabetic neuropathy ( = <0.001), retinopathy ( = <0.001) and nephropathy ( = <0.001) had significantly higher SHQ scores. Insulin or SU use was associated with a significantly higher SHQ score. Concomitant statin use was associated with a lower incidence of mild, moderate and severe hypoglycaemia ( = 0.01). On multivariate analysis, we found that age, sex, systolic blood pressure (SBP), insulin use and fasting blood sugar were the most important factors associated with an increased risk of hypoglycaemia with an R cut-off of 0.7.
SHQ was discovered to be a simple and cost-effective screening tool for outpatient detection of hypoglycaemia in an Indian setting, and it can add value to management.
本研究旨在通过在实际情况中使用斯坦福低血糖问卷（SHQ）筛查，确定接受抗糖尿病药物治疗的2型糖尿病（T2DM）患者中未报告的可能低血糖的发生率。
这是一项针对印度北方邦勒克瑙10个糖尿病护理中心连续就诊个体的多中心横断面研究。纳入标准如下：已知的T2DM患者、识字、年龄大于或等于18岁、使用至少一种抗糖尿病药物超过一个月且未进行常规血糖自我监测（SMBG）。
本研究于2017年8月至2018年4月进行，涉及1198名参与者。纳入个体的平均年龄为53.45岁（±10.83），男性占人口的55.3%。发现63.6%的患者使用磺脲类药物（SU），14.5%使用吡格列酮，92.2%使用二甲双胍，62.3%使用二肽基肽酶（DPP4i），12.8%使用钠-葡萄糖协同转运蛋白（SGLT2i）。SHQ平均得分为1.81（±1.59）。可能的低血糖轻度占57.59%，中度占14.69%，重度占1.41%。患有糖尿病神经病变（P<0.001）、视网膜病变（P<0.001）和肾病（P<0.001）的患者SHQ得分显著更高。使用胰岛素或SU与显著更高的SHQ得分相关。同时使用他汀类药物与轻度、中度和重度低血糖发生率较低相关（P = 0.01）。多变量分析显示，年龄、性别、收缩压（SBP）、胰岛素使用和空腹血糖是与低血糖风险增加相关的最重要因素，R截止值为0.7。
在印度环境中，SHQ被发现是一种简单且经济高效的门诊低血糖筛查工具，可为管理提供价值。
