Risk Factors For Hypoglycemia And Glucose Excursion After Various Hypoglycemia Treatments In Type 2 Diabetes Patients

Aims:In this paper, we aim to explore the potential risk factors for hypoglycemia and evaluate the effects of different treatment methods for hypoglycemia on glucose fluctuation.Methods:We recruited 564 type 2 diabetes patients who are in the department of endocrinology of Qilu Hospital from Jan of 2013 to Dec of 2014 according to exclusion criteria. Diabetes is defined based on the diagnostic criteria of 1999 WHO; hypoglycemia is defined as blood glucose lower than 3.9mmol/L. Then we finally included 320 subjects who developed hypoglycemia and 240 patients who did not have hypoglycemia while in hospital. Cookies and sugar packets. A standard questionnaire was used to collect the information of demographic characteristics by trained investigators. Data were collected from laboratory results of patients during hospitalization. The risk factors were analyzed including age,BMI, waist circumference,systolic blood pressure,diastolic blood pressure,fasting plasma glucose,HbAlc level,triglycerides,total cholesterol, low-density lipoprotein, high-density lipoprotein, smoke,drink,urinary micro-albumin,common food intake etc According to the different treatment methods for hypoglycemia, all subjects were divided into three groups:one group ate a lot of food by themselves; one group ate cookies follow the directions; one group drinked sugar water follow the directions. Data are presented as mean ± SD for continuous variables and number (%) for categorical variables. Differences between groups were analyzed by one-way ANOVA (LSD) for continuous data and Chi-square test for categorical data. P<0.05 was considered statistically significant. All statistical analyses were performed using SPSS 16.0.Results:1.Compared to patients without hypoglycemia,patients who experienced hypoglycemia were older and had higher SBP、DBP、albuminuria、rate of drinking, but lower BMI and HDL.2.By using multivariate logistic regression, our data showed that age、albuminuria and drinking are the independent risk factors for hypoglycemia in patients with type 2 diabetes.BMI may be the independent protective factor for hypoglycemia in patients with type 2 diabetes.3.When hypoglycemia occurred, no significant differences in blood glucose levels of three groups were observed.15 minutes after processing, blood glucose rise faster in irregular eating group and drinking sugar water group, which is significantly higher than eating cookies group. Then, there was no significant difference of blood glucose between three groups.4. The glucose fluctuation index (the standard deviation of seven times blood glucose) was not different between irregular eating group and drinking sugar water group. However, the glucose fluctuation was significantly lower in eating cookies group.Conclusions:For type 2 diabetes patients, age、albuminuria and drinking are the independent risk factors and BMI is the independent protective factor for hypoglycemia. After the occurrence of hypoglycemia, eating a moderate amount of cookies containing carbohydrate, protein and fat can effectively correct hypoglycemia and can avoid the excessive fluctuation of blood glucose compared with irregular eating group and drinking sugar water group, thus, could reduce the damage caused by blood glucose fluctuation.