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接受胰岛素治疗的2型糖尿病患者低血糖的发生频率及症状

Frequency and symptoms of hypoglycaemia experienced by patients with type 2 diabetes treated with insulin.

作者信息

Hepburn D A, MacLeod K M, Pell A C, Scougal I J, Frier B M

机构信息

Department of Diabetes, Royal Infirmary, Edinburgh, Scotland.

出版信息

Diabet Med. 1993 Apr;10(3):231-7. doi: 10.1111/j.1464-5491.1993.tb00050.x.

Abstract

This study ascertained the prevalence of severe hypoglycaemia and loss of awareness of hypoglycaemia in patients with Type 2 diabetes treated with insulin. One hundred and four sequentially selected Type 2 diabetic patients were compared with 104 patients with Type 1 diabetes who were matched for duration of insulin therapy. The patients were interviewed using a standardized questionnaire. During treatment with insulin, 18 Type 2 patients had experienced fewer than two episodes of hypoglycaemia, while 86 had experienced two or more episodes; 80 (93%) reported normal awareness, six (7%) reported partial awareness, and none had absent awareness of hypoglycaemia. All 86 Type 1 diabetic patients matched to the 86 Type 2 patients had experienced multiple episodes of hypoglycaemia; 71 (83%) had normal awareness, 14 (16%) had partial awareness and one patient (1%) reported absent awareness of hypoglycaemia. The Type 1 patients who had altered awareness of hypoglycaemia had longer duration of diabetes and insulin therapy (normal awareness: 5 (1-17) years (median (range)) vs partial awareness: 9 (3-18) years, p < 0.01). Similarly, Type 2 patients with altered awareness had longer duration of diabetes (normal awareness: 11 (2-25) years vs partial awareness: 19 (8-24) years, p < 0.02) and had received insulin for longer (normal awareness: 3 (1-18) years vs partial awareness: 12 (6-17) years, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究确定了接受胰岛素治疗的2型糖尿病患者中严重低血糖症的患病率以及低血糖意识丧失的情况。将104例按顺序选取的2型糖尿病患者与104例胰岛素治疗时长匹配的1型糖尿病患者进行比较。使用标准化问卷对患者进行访谈。在胰岛素治疗期间,18例2型患者经历的低血糖发作少于两次,而86例经历了两次或更多次发作;80例(93%)报告低血糖意识正常,6例(7%)报告部分意识存在问题,无人完全丧失低血糖意识。与86例2型患者匹配的所有86例1型糖尿病患者均经历过多次低血糖发作;71例(83%)意识正常,14例(16%)部分意识存在问题,1例患者(1%)报告完全丧失低血糖意识。低血糖意识改变的1型患者糖尿病和胰岛素治疗时长更长(意识正常:5(1 - 17)年(中位数(范围))vs部分意识存在问题:9(3 - 18)年,p < 0.01)。同样,意识改变的2型患者糖尿病病程更长(意识正常:11(2 - 25)年vs部分意识存在问题:19(8 - 24)年,p < 0.02),且接受胰岛素治疗的时间也更长(意识正常:3(1 - 18)年vs部分意识存在问题:12(6 - 17)年,p < 0.001)。(摘要截断于250字)

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