Causes Analysis Of Hypoglycemia In Diabetes During The Therapy And Observation About The Level Of CRP After Hypoglycemia

Objective: To explore the reasons for hypoglycemia during the therapyfor diabetes mellitus,and observe the change of High Sensitivity C-ReactiveProtein level after hypoglycemia,and provide some guidance for the preventionof hypoglycemia in diabetes in the clinical work.Materials and methods:1. The subjects:200diabetic patients are observed from theEndocrinology Department of our hospital From December2009to September2011. According to whether hypoglycemia occurs, the diabetic patients aredivided into2groups.100diabetic patients without hypoglycemia are choosenas the control group.100diabetic patients who are admitted to hospital becauseof hypoglycemia or have hypoglycemia during hospitalization are choosen asthe observation group.2. Inclusion criteria:(1) The diagnosis of diabetes mellitus accorded withthe new diagnostic criteria of WHO in1999（.2）Diagnostic criteria for diabeteshypoglycemia: a：have symptoms of hypoglycemia；b：the blood glucose≤3.9mmol/L when hypoglycemia happens, c：and the symptom will relieve aftertaking food or injecting glucose. The item b is the necessary condition fordiagnosis.3. Study methods:（1）Blood glucose measurement during hypoglycemiain the observation group：Diabetic patients who are admitted to hospitalbecause of hypoglycemia need the venous blood glucose≤3.9mmol/l collectedin outpatient department, emergency or after being admitted to hospital.Meeting that can be choosen as the observation group. Diabetic patients whohave hypoglycemia symptoms during hospitalization use glucometer to take Peripheral blood for testing blood glucose.(or there are not hypoglycemiasymptoms but the blood glucose≤3.9mmol/L during blood glucosemonitoring) And the result should be validated by venous blood at the sametime.If venous blood glucose≤3.9mmol/L，the patient can be choosen as theobservation group.(2) the control group take10days as the observationdeadline, using glucometer to monitor blood glucose, If there is not bloodglucose≤3.9mmol/L，the patient can be choosen as the control group.（3）All the patients into the group are gathered clinical Materials including: Age,gender, duration of diabetes, body mass index(BMI).（4）All the patients aredrawn venous blood in the next morning after fasting8hours,and the patientsof observation group need to be drawn venous blood after glucostasis.Testingcontent include：fasting plasma glucose（FPG）, alanine transaminase (ALT),serum creatinine（Cr）; glycosylated hemoglobin（HbA1c）,gathering24h urinespecimens to examine urinary microalbumin（UMA）.(5) After hypoglycemia,the patients of observation group are drawn venous blood in the next morningto measure serum high sensitivity C-Reactive Protein. The patients of controlgroup are drawn venous blood in the morning after10days hospitalization tomeasure serum high sensitivity C-Reactive Protein.（6）The treatments and theinducing factors of hypoglycemia are statistically analyzed by talking methodin observation group.4. Statistical methods: SPSS16.0statistical software is applied to analyzethe data. The measurement data of normal distribution and meetinghomogeneity of variance is expressed by mean±standard deviation,andindependent samples t test is applied to compare the means of the two samples.The measurement data of abnormal distribution is expressed by median(lowerquartile，upper quartile),and independent samples rank sum test is applied tocompare them. Count data is expressed by relative number and Χ2test is applied to compare the two groups. After evaluate the main research factors,usewhether it has hypoglycemia as the dependent variable, the clinical andbiochemical characteristics as the independent variable to carry throughmultifactor logistic regression analysis.Results:（1）The observation group compared with the control group:Body mass index is significantly lower but age, duration of diabetes，creatinine and urinary microalbumin are obviously higher in the observationgroup than in the control group,and the differences have statistical significance（P <0.05）.The differences of other elements between the two groups haven’tstatistical significance（P>0.05）.（2）The results of multifactor logisticregression analysis indicate that age，creatinine and urinary microalbumin arethe independent risk factors for hypoglycemia,while BMI is a protective factorof hypoglycemia in patients with diabetes（P <0.05）.（3）Using premixedhuman insulin twice a day takes a largest proportion in all kinds of treatmentsin the observation group.(4) Irregular diet takes a largest proportion in all kindsof reasons leading to hypoglycemia that can be known when hypoglycemiahappens. Over strict blood sugar control takes a largest proportion in all kindsof reasons leading to hypoglycemia that can not be known when hypoglycemiahappens, but after treatment, through analysis we find the reasons.Conclusion:(1)The occurrence of hypoglycemia during the treatment indiabetic patients is closely related to age,BMI, creatinine and urinarymicroalbumin. The occurrence of hypoglycemia in diabetic patients is a resultof a comprehensive effect of many factors.(2) Hypoglycemia and dramaticfluctuations in blood glucose closely related to the hypoglycemia can lead tothe body injuiry.The injury of a dramatic fluctuation in blood glucose will bemore serious than continued high blood glucose. As a kind of inflammatoryfactor and a maker of tissue damage,hs-CRP has definite value to evaluation ofthe impairment result from hypoglycemia and blood glucose fluctuations.