Jaap A J, Jones G C, McCrimmon R J, Deary I J, Frier B M
Department of Diabetes, Royal Infirmary of Edinburgh, UK.
Diabet Med. 1998 May;15(5):398-401. doi: 10.1002/(SICI)1096-9136(199805)15:5<398::AID-DIA595>3.0.CO;2-B.
Elderly insulin-treated diabetic patients have a high risk of severe hypoglycaemia, yet their hypoglycaemic symptom profile has attracted little research. In this study, the frequency and intensity of symptoms of hypoglycaemia were recorded using a validated questionnaire in 132 insulin-treated diabetic patients, aged 70 years or more. Principal components analysis (PCA) was used to discover the factorial structure of the symptoms. Lightheadedness and unsteadiness were prominent symptoms in the elderly patients. PCA suggested three separate groups of symptoms: (1) those related specifically to impairment of co-ordination and articulation; (2) more general neuroglycopenic symptoms, and (3) autonomic symptoms. The frequency and classification of hypoglycaemic symptoms in this elderly population is different from those seen in younger diabetic patients treated with insulin. Neurological symptoms of hypoglycaemia were more commonly reported and may be misinterpreted as features of cerebrovascular disease. Health professionals and carers involved in the treatment and education of diabetic patients should be aware of the age-specific differences in hypoglycaemic symptoms.
老年胰岛素治疗糖尿病患者发生严重低血糖的风险很高，然而他们的低血糖症状特征却很少受到研究关注。在本研究中，使用一份经过验证的问卷记录了132名年龄在70岁及以上的胰岛素治疗糖尿病患者的低血糖症状发生频率和严重程度。主成分分析（PCA）用于发现症状的因子结构。头晕和站立不稳是老年患者的突出症状。主成分分析表明存在三组不同的症状：（1）与协调和言语表达受损特别相关的症状；（2）更一般的神经低血糖症状，以及（3）自主神经症状。该老年人群低血糖症状的发生频率和分类与年轻胰岛素治疗糖尿病患者不同。低血糖的神经症状更常被报告，可能会被误解为脑血管疾病的特征。参与糖尿病患者治疗和教育的医护人员及护理人员应了解低血糖症状的年龄特异性差异。
