| Hypoglycemia is a clinical syndrome caused by various reasonswhen the blood glucose concentration is too low. Clinical symptoms aremainly affected by various manifestations of sympathetic nervestimulation and the central nervous system by a hypoglycemic effect. Themain goal of treatment is to control blood glucose in diabetic patients,make blood glucose long-term stable and standard so as to reduce theacute and chronic complications, with the promotion of intensive insulintherapy and a variety of drugs, the control of blood glucose become moreand more effectively in diabetes patients and the hypoglycemia rateincreases higher and higher. Through the clinical analysis of inpatientswith hypoglycemia, find out the effective method of preventinghypoglycemia.Objective：The purpose of this study is to explore the predisposingfactors of inpatients with hypoglycemia and guide clinical treatment toavoid hypoglycemia occurrence through the systematic analysis of age,sex, course of disease, complication, symptoms, occurrence time andtreatment in each inpatient with hypoglycemia. Materials and Methods： Data were selected based onendocrinology and metabolism department of First Bethune Hospital ofJilin University from December2014to March2015. There were132cases which were considered to be with hypoglycemia in fingertip bloodglucose monitoring of all the diabetes mellitus inpatients. All the patientsmeet the diagnostic criteria on diabetes of world health organization(WHO) in1999: Polydipsia, polyphagia, polyuria, weight loss and othersymptoms of high blood sugar; fasting plasma glucose≥7.0mmol/l,75gglucose tolerance2h plasma glucose≥11.1mmol/l, random venousplasma glucose≥11.1mmol/l. At the same time satisfy the two or moreconditions can be diagnosed. Diabetic hypoglycemia diagnostic criteria:Blood glucose is lower than3.9mmol/l. Reference to the Americandiabetes association and the classic diabetes complications and controltest defined severe hypoglycemia as people who need intake ofcarbohydrate with help, intravenous infusion of glucose, application ofglucagon and other measures to recover the low blood sugar, or glucosevalue below2.8mmol/l. According to the diagnostic criteria of theseventh edition of the complications of Department of internal medicine,including: Diabetic patients with nephropathy, diabetic peripheralneuropathy, diabetic retinopathy, diabetic patients with cardiovasculardisease and diabetic foot. Observation contents: Each occurrence ofhypoglycemia in patients with sex, age, type, occurrence time, duration, complications, hospitalization duration, hemoglobin A1c, treatment,cause, BMI and symptom. Research methods: Create the database withExcel. The incidence of hypoglycemia (%)=the number ofhypoglycemia/the total number of glucose monitoring×100%.Results：(1)Diabetes mellitus inpatients monitor a total number of20880times with peripheral blood glucose from December2014toMarch2015,132cases of hypoglycemia, the incidence rate ofhypoglycemia was0.63%, the occurrence of severe hypoglycemia was15cases, the incidence rate was0.72‰. In15cases of severe hypoglycemia,there was no serious sequelae of the nervous system and cardiovascularsystem happened. Cases of male’s to female’s ratio of hypoglycemia are63：69.(2)In the comparison of different ages in the frequency ofhypoglycemia, the incidence of hypoglycemia in the highest number isgreater than60years (including60years) group.(3)Of all the diabetesmellitus inpatients with hypoglycemia, there were55cases happened atfasting, before lunch and dinner, there were34cases happened aftermeals, and43cases before going to bed and during the night.(4)The timesfor the course of0-10years with hypoglycemia cases up to64, for11-20years were60and21-30years were8.(5)Combined with microvascularcomplications up to67cases, with nerve lesions were38cases, with largevascular lesions were37cases, with diabetic foot were2cases.(6)Thenumber of hypoglycemia inpatients whose hospitalization days≤3days was34cases,4to5days for34cases,7days or more for up to64times.(7)The occurred time of hypoglycemia on diabetes patients whosehemoglobin A1c>7.0%was up to99, hemoglobin A1c between6.5%and7.0%was24cases, A1c <6.5%was9cases.(8)Receiving intensiveinsulin therapy occurred hypoglycemia diabetes mellitus inpatients casesfor a maximum of76times. The conventional insulin treatment groupoccurred hypoglycemia was48cases, oral hypoglycemia drug groupoccurred5cases, simple diet and exercise control group occurred3cases.(9)The cases of hypoglycemia caused by drug overdose (includinginsulin and oral hypoglycemia agents) were up to63cases, by exerciseand diet unreasonably cause were29cases and46casesrespectively.(10)There were84cases of hypoglycemia in BMI <25kg/m2group,36cases in BMI25-30kg/m2group,12cases in BMI>30kg/m2group.(11)There are45cases appeared asymptomatic hypoglycemia,accounting for34.09%of the total.Conclusions：(1)Diabetes mellitus inpatients monitor a total numberof20880times with peripheral blood glucose from December2014toMarch2015, the incidence rate of hypoglycemia was0.63%, theincidence rate of severe hypoglycemia was0.72‰.(2)The incidence ofhypoglycemia in diabetic patients is caused by multiple factors, it may berelated to patient’s age, gender, duration, body mass index, complications,treatment, diet and exercise. Reducing risk factors, strengthen the monitoring of blood glucose, setting up individualized treatmentcooperating with doctors and patients is the key in the development ofdiabetes treatment. |
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