Ito Hiroyuki, Shibuya Mizuho, Iwami Riko, Ina Hitomi, Okawa Masayo, I Chiaki, Miura Shun, Matsumoto Suzuko, Inoue Hideyuki, Antoku Shinichu, Yamasaki Tomoko, Mori Toshiko, Toagane Michiko
Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Japan.
Department of Nursing, Edogawa Medicare Hospital, Japan.
Intern Med. 2024 Nov 28. doi: 10.2169/internalmedicine.4546-24.
Objective To determine the clinical background factors of patients with type 2 diabetes who showed deterioration of defecation status after hospitalization. Methods The defecation status of 128 patients with type 2 diabetes who were admitted to our department for diabetes education was evaluated for 7 days after hospitalization. New-onset constipation was diagnosed when patients without constipation before hospitalization met the criteria for constipation after hospitalization. Worsening constipation was diagnosed when patients with constipation required a larger laxative dose than that before hospitalization. New-onset constipation and worsening constipation were defined as the deterioration of defecation status. The major outcome was the incidence of deterioration of defecation status after hospitalization. Results After hospitalization, 23 of 99 patients who had no constipation before hospitalization developed new-onset constipation. Among the 29 patients with constipation before hospitalization, 9 showed worsening constipation. Overall, 52 patients (41% of all subjects) had constipation, and 32 (25% of all subjects) were diagnosed with deterioration in defecation status. In univariate logistic regression analyses, patient age, albuminuria, diabetic peripheral neuropathy, AST, eGFR, HbA1c, and baPWV were significantly associated with deterioration in defecation status. In the multivariate logistic regression analyses, albuminuria was the only factor that showed a significant association with the deterioration of defecation status after hospitalization. Conclusion Constipation is highly prevalent among hospitalized patients with type 2 diabetes. Paying attention to albuminuria is useful for facilitating an appropriate response to the deterioration of defecation status in patients with type 2 diabetes after hospitalization.
目的 确定住院后排便状况恶化的2型糖尿病患者的临床背景因素。方法 对因糖尿病教育入住我科的128例2型糖尿病患者住院后7天的排便状况进行评估。住院前无便秘的患者在住院后符合便秘标准时诊断为新发便秘。便秘患者所需泻药剂量比住院前大时诊断为便秘加重。新发便秘和便秘加重定义为排便状况恶化。主要结局是住院后排便状况恶化的发生率。结果 住院后,99例住院前无便秘的患者中有23例出现新发便秘。在29例住院前有便秘的患者中,9例便秘加重。总体而言,52例患者(占所有受试者的41%)有便秘,32例(占所有受试者的25%)被诊断为排便状况恶化。在单因素逻辑回归分析中,患者年龄、蛋白尿、糖尿病周围神经病变、AST、估算肾小球滤过率(eGFR)、糖化血红蛋白(HbA1c)和臂踝脉搏波速度(baPWV)与排便状况恶化显著相关。在多因素逻辑回归分析中,蛋白尿是唯一与住院后排便状况恶化显著相关 的因素。结论 便秘在住院的2型糖尿病患者中非常普遍。关注蛋白尿有助于对2型糖尿病患者住院后排便状况恶化做出适当反应。
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