Jayasekera Priyamali Thusharika, Senaratne Thamarasi, Lamabadusuriya Dilusha, Sathischandra Harsha, Matthias Anne Thushara, Jayasekera Pubudu, Herath Mettananda, De Zoysa Warsha Dilani, Senaratne Ganaka, Pathirage Manoji, Jayasinghe Kumuduni, Karunaratne Shashi, Sudarshan Ponnuthurai, Sujanitha Vathulan, Rajaratnam Nalayni, Wickramaratne Deeptha, Umakanth Maheshwaran, Ratnayake Bandusiri, Rasnayake Lalith, Liyanage Roshan, Pushpakumara Jagath, Wanigarathne Thushari, Siriwardhane Prasad, Kumara Yapa Udaya, Kuruppu Shanil, Edirisinghe Deepthi, Wijesinghe Namal
Department of Medicine, Faculty of Medicine, General Sir John Kotelawala Defence University, Colombo, Sri Lanka.
Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Colombo, Sri Lanka.
J Diabetes Res. 2025 Aug 22;2025:4412070. doi: 10.1155/jdr/4412070. eCollection 2025.
Hypoglycemia has been an often-neglected complication of diabetes therapy. Mild hypoglycemia reduces quality of life, while severe hypoglycemia is life-threatening and can precipitate major cardiovascular and cerebrovascular events. A multicenter cross-sectional study was conducted on hypoglycemia among adults with diabetes attending 19 medical clinics in government hospitals in Sri Lanka using an interviewer-administered questionnaire. There were 2005 participants, and 1110 (55.4%) were < 65 years of age and 895 (44.6%) were > 65 years of age; the mean age was 62.12 ± 11.94 years (58.1% female). The median duration of diabetes was 8 (IQR11) years. Among them, 808 (43%), 757 (37.8%), and 376 (18.8%) had neuropathy, retinopathy, and nephropathy, respectively, while 415 (20.7%), 50 (2.5%), and 22 (1%) had ischemic heart disease, strokes, and peripheral vascular disease, respectively. One thousand three hundred forty-nine (67.3%) experienced at least one episode of hypoglycemia, and 462 (34.2%) had hospital admissions (9 (0.7%) intensive care admissions) over the past year. Older adults ( = 584) experienced significantly more symptomatic hypoglycemia compared to the younger population ( ≤ 0.001). Their mean CBS during hypoglycemic episodes was 57.04 ± 18.15 mg/dL. Among them, 1552 (77.4%) were on oral hypoglycemic medications, 453 (22.6%) were on insulin, and 126 (6.3%) were on both. The most typical reasons for hypoglycemia were skipping meals while taking regular medications (511, 37.9%), consumption of sugar-reducing native food items (203, 15%) and taking higher doses of insulin (112, 8.3%) and oral medication (74, 5.5%) than prescribed. To self-manage hypoglycemia, 1070 (79.3%) took sugary drinks, food, or glucose, and 279 (20.7%) did not do anything. There were 304 (34%) frail older adults, and 238 (78.3%) got hypoglycemia. They were taking similar prescriptions as young adults. They displayed significant hypoglycemic symptoms such as dizziness, irritability, nausea, speech impediment, and blurred vision compared to nonfrail elders ( ≤ 0.01). There were 485 diabetic patients who either drove or rode in a vehicle; 51 (10.5%) of them had experienced hypoglycemia during driving or riding. Hypoglycemia is a significant issue which needs to be addressed. There is no difference in prescription medication in age categories and frail patients. Driving and hypoglycemia are also a concerning issue. Patients need advice on the prevention and treatment of hypoglycemia.
低血糖一直是糖尿病治疗中一个常被忽视的并发症。轻度低血糖会降低生活质量，而严重低血糖则会危及生命，并可能引发重大的心脑血管事件。一项多中心横断面研究在斯里兰卡政府医院的19家诊所对成年糖尿病患者的低血糖情况进行了调查，采用的是访谈式问卷调查。共有2005名参与者，其中1110名（55.4%）年龄小于65岁，895名（44.6%）年龄大于65岁；平均年龄为62.12±11.94岁（女性占58.1%）。糖尿病的中位病程为8（四分位间距11）年。其中，分别有808名（43%）、757名（37.8%）和376名（18.8%）患有神经病变、视网膜病变和肾病，而分别有415名（20.7%）、50名（2.5%）和22名（1%）患有缺血性心脏病、中风和外周血管疾病。1349名（67.3%）患者至少经历过一次低血糖发作，462名（34.2%）在过去一年中曾住院治疗（9名（0.7%）入住重症监护病房）。与年轻人群相比，老年人（=584）出现有症状低血糖的情况明显更多（≤0.001）。他们在低血糖发作期间的平均血糖浓度为57.04±18.15mg/dL。其中，1552名（77.4%）服用口服降糖药，453名（22.6%）使用胰岛素，126名（6.3%）两者都用。低血糖最常见的原因是在规律服药时不吃饭（511例，37.9%）、食用降糖的当地食物（203例，15%）以及服用的胰岛素（112例，8.3%）和口服药物（74例，5.5%）剂量高于规定剂量。为了自我处理低血糖，1070名（79.3%）患者饮用含糖饮料、进食或服用葡萄糖，279名（20.7%）患者未采取任何措施。有304名（34%）体弱老年人，其中238名（78.3%）出现了低血糖。他们服用的处方与年轻人相似。与非体弱老年人相比，他们出现了明显的低血糖症状，如头晕、易怒、恶心、言语障碍和视力模糊（≤0.01）。有485名糖尿病患者开车或乘车；其中51名（10.5%）在开车或乘车时经历过低血糖。低血糖是一个需要解决的重要问题。不同年龄组和体弱患者在处方药方面没有差异。开车与低血糖也是一个令人担忧的问题。患者需要得到关于低血糖预防和治疗的建议。
