The Analysis Of Characteristics And Related Risk Factors Of Hypoglycemia Among Hospitalized Patients With Diabetes Millitus

Hypoglycemia is a set of clinical syndrome caused by plasma glucose concentration is too low, it is caused by a variety of causes and the main clinical manifestations are excitement of sympathetic nerve and brain dysfunction. With the development of new drugs of treating diabetes millitus, glucose control is more and more standard, but the incidence of hypoglycemia is also increasing, hypoglycemia has become a major limiting factor in the process of diabetes treatment, it not only increases the patients’ pain and becomes a serious threat to the patients’ life and health, but also causes great economic losses to the state and the individual. Therefore, to avoid the occurrence of hypoglycemia in the process of diabetes treatment is crucial.Objective:The purpose of this study was to analyse the characteristics of hypoglycaemia, explore the related risk factors, evaluate the hospital blood glucose management thorough the systematic analysis of age, sex,course, glycosylated hemoglobin, body mass index, glucose monitoring data, treatments, etc.Materials and Methods:Collected 20693 times glucose monitoring data of 408 patients withdiabetes millitus in endocrinology and metabolism department of First Bethune Hospital of Jilin University from September to October 2015,retrospectively analyzed the incidence of hypoglycemia, explored the characteristics and risk factors of hypoglycemia. Inclusion criteria:(1)Diagnostic criteria of diabetes millitus: All the patients were consistent with the diagnostic criteria on diabetes of world health organization in1999;(2) Diagnostic criteria of hypoglycemia: According to the 2013 edition of "Diabetes Prevention Guide of Diabetes in China", whether the fasting blood glucose or not, the level of glucose less than 3.9mmol/L belongs to the category of hypoglycemia;(3) Type 1 or type 2 diabetes;(4)During the period of hospitalization all patients monitored blood glucose with Johnson blood glucose meter. Exclusion criteria:(1) The gestational diabetes;(2) Secondary diabetes;(3) Hospital glucose monitoring frequency less than 10 times. Observation of content: each patient’s age,sex, glycated hemoglobin, duration, body mass index, type of diabetes,occurrence time, hypoglycemia times, and glucose monitoring datas.Statistical methods: SPSS21.0 software was used to analyse data. Count data was expressed as percentage, the measured data was expressed by mean, standard deviation, maximum and minimum value, and the chi-square test was used in the comparison of different groups. Firsely, a single factor analysis was used to analyze the difference of the incidence of hypoglycemia between different groups, The non conditional Logisticregression analysis was used to analyze the statistically significant variables.Results:1. 408 patients of diabetes millitus monitored glucose data a total of20693 times, 80 cases of hypoglycemia, 143 times of hypoglycemia, the incidence rate of hypoglycemia is 19.6%, the incidence density of hypoglycemia is 0.69%.2. The highest rate of hypoglycemia is the period before lunch,followed by bedtime and night.3. In the different age and the incidence of hypoglycemia in comparison, more than 60 years old with diabetes hypoglycemia rate is the highest for 26.60%.4. Incidence rare of hypoglycemia of patients with diabetes duration more than 10 years is 27.03%, the incidence rate of hypoglycemia of diabetes duration in 5 to 10 years is 16.90%, the incidence rate of hypoglycemia of diabetes duration less than 5 years is 12.40%.5. The incidence rate of hypoglycemia of diabetic patients with Hb A1 c less than 7% is 27.03%, the rate of hypoglycemia of diabetic patients with Hb A1 c in 7% to10% is 18.13%, the rate of hypoglycemia of diabetic patients with Hb A1 c more than 10% is 11%.6. All subjects received treatment during hospitalization were:subcutaneous insulin injection(39.5%), insulin and oral hypoglycemicdrugs(31.4%), insulin pumps(13.7%), with a single oral antidiabetic drugs(11.3%), not treatment(4.2%). In all treatment options, the application of insulin pump therapy in diabetic patients with low blood sugar highest incidence of 31.10%, followed by subcutaneous insulin injections for 21.10%.7. The incidence rate of hypoglycemia of diabetic patients with body mass index less than 25 Kg / m2 is highest of 25.78%.8. The incidence rate of hypoglycemia of patients with type 1diabetes is 50%, the incidence rate of hypoglycemia of patients with type2 diabetes is 18.5%.9. Logistic regression analysis shows that diabetic duration more than 10 years, glycated hemoglobin less than 7%, intensive insulin therapy, body mass index less than 25Kg/m2 are risk factors of hypoglycemia(P <0.05).Conclusions:1. Collected 20693 times glucose monitoring data of 408 patients with diabetes millitus in endocrinology and metabolism department of First Bethune Hospital of Jilin University from September to October2015, the incidence rate of hypoglycemia is 19.6%, the incidence density of hypoglycemia is 0.69%.2. Before lunch, before dinner and before bedtime hypoglycemia incidence rate is higher, should strengthen the high incidence period ofblood glucose monitoring.3. Diabetic patients with hypoglycemia is the result of multiple factors, the course of more than 10 years, glycosylated hemoglobin is less than 7%, body mass index less than 25Kg/m2, intensive insulin therapy is the risk factors of hypoglycemia.