Potter J, Clarke P, Gale E A, Dave S H, Tattersall R B
Br Med J (Clin Res Ed). 1982 Oct 23;285(6349):1180-2. doi: 10.1136/bmj.285.6349.1180.
In one year a prospective survey in a large accident and emergency department identified 204 admissions of adults with severe hypoglycaemia, 200 in insulin-treated patients. Ninety-six had one admission while 34 others were admitted on 104 occasions. Of the 130 patients, 111 attended diabetic clinics in Nottingham, forming 9% of a known clinic population of 1229 on insulin treatment. Since many other episodes of hypoglycaemia were presumably treated outside hospital, 9% a year is a minimum estimate of the incidence of severe hypoglycaemia in our area. The mean insulin dose was 1.2 units/kilogram/day for those admitted twice or more and 0.9 U/kg/day for those admitted once; these doses were significantly higher than those of an age-matched clinic population. A year after the latest admission with hypoglycaemia, the mean insulin dose in the group with two or more admissions had fallen to 0.8 U/kg/day, suggesting that over-treatment had been an important causal factor. A similarly high incidence has been reported in other studies, and we believe that it is due mainly to the inadequacy of conventional subcutaneous insulin treatment.
在一年时间里，一项针对一家大型急诊科的前瞻性调查发现，有204名成年严重低血糖患者入院，其中200名是接受胰岛素治疗的患者。96人入院一次，另外34人入院104次。在这130名患者中，111人前往诺丁汉的糖尿病诊所就诊，占已知1229名接受胰岛素治疗的诊所患者群体的9%。由于许多其他低血糖发作可能在院外得到治疗，因此每年9%是我们地区严重低血糖发病率的最低估计值。两次或更多次入院患者的平均胰岛素剂量为1.2单位/千克/天，入院一次的患者为0.9单位/千克/天；这些剂量明显高于年龄匹配的诊所患者群体。在最近一次因低血糖入院一年后，两次或更多次入院组的平均胰岛素剂量降至0.8单位/千克/天，这表明过度治疗是一个重要的因果因素。其他研究也报告了类似的高发病率，我们认为这主要是由于传统皮下胰岛素治疗的不足。
