| Objective:To retrospective analysis the prevalence of hypoglycemia in admission adult patients with diabetes, and investigate the characteristics and related risk factors of hypoglycemia in admission patients, to optimize the hospital blood glucose management.Methods:813patients, who were hospitalized in the Endocrinology Department in the Sixth Affiliated Hospital of Guangxi Medical University, were enrolled from January,2013to December,2013and the data of49381times of glycemic detection were collected during the whole year study with the usage of OTDMS program. To retrospective analysis the characteristics and related risk factors of hypoglycemia in hospitalized patients.Results:1.Totally813(male/female:429/384) patients with diabetes mellitus were hospitalized during the study. These patients accept different treatment options respectively, insulin pump (55.96%)>subcutaneous insulin therapy (31.74%)>OAD (7.14%)> OAD and subcutaneous insulin (2.95%)>diet and exercise only (2.22%).90.6%were treated with insulin in the whole813subjects, and insulin pump was the highest implements among all the strategies (55.96%) 2.49381times of glycemic detection were performed during the study, the general frequency ranks from high to low is as follow:post-breakfast (15.32%)>pre-breakfast (15.03%)> post-lunch (14.59%)>pre-sleep (13.14%)>post-dinner (12.65%)>nocturnal(10.3%)>pre-lunch (9.49%)>pre-dinner (9.4%)3. The frequency of hypoglycemia is1.67%in hospitalized patients with diabetes mellitus, calculated by the number of hypoglycemia (825/49381), and the severe hypoglycemia is0.27%, The high frequency of hypoglycemia happens in nocturnal (118/5089,2.32%), pre-lunch (106/4687,2.26%), pre-dinner (95/6249,2.03%).4.285patients had hypoglycemia in the total813patients during the study (accounts for35.06%of the total number of hospitalized patients),49.5%of hypoglycemia was asymptomatic, and hunger, diaphoresis, dizziness, palpitations, fatigue and so on accounts for18.86%.15.81%>12.5%n8.38%and6.86%respectively.138patients had one time of hypoglycemic attack (48.42%),76patients (26.67%) had two times of hypoglycemia attack,71patients had three or more times of hypoglycemiaattack (24.91%)5. The incidence ofhypoglycemiawithT1DM and T2DM patients was33.29%,62.0%respectively (P<0.001), and T1DMpatients had three or more times of hypoglycemia attack accounts for58.06%of the total number of T1DM patients who had happened hypoglycemia.6. The highest rate of hypoglycemia with different therapeutic strategies was subcutaneous insulin usage group (39.53%),and the second was insulin pump usage group (35.38%),the lowest was the OAD usage group (20.69%), the rate of hypoglycemia compared with different between groups was statistically significant differences. 7. The type1diabetes mellitus, insulin usage, less than7%of glycosylated hemoglobin level and more than10years of duration of diabetes were the risk factors of hypoglycemia in hospitalized adult patients with diabetes mellitus according to the binary logistic regression analysis (P?0.05)Conclusion:1.The frequency of hypoglycemia is1.67%in hospitalized patients with diabetes during the study, but35.06%(285/813) of the patients during hospitalized experience hypoglycemia and51.58%of them will have recurrent episodes.Prompt the patient with diabetes is high risk of hypoglycemia, and the event may be repeated?2. During hospitalization, the highest rate of hypoglycemia is in nocturnal, and followed by pre-lunch and pre-dinner, suggesting that we have to strengthen glucose monitoring and prevention.3. Most of the hypoglycemic symptoms was asymptomatic, suggest that we need to alert to the occurrence of asymptomatic hypoglycemia, which can help prevent the occurrence of severe hypoglycemia.4. Type1diabetes, insulin therapy, HbA1C level less than7.0%and duration more than10years significantly increase the risk of hypoglycemia in hospitalized adult patients with diabetes. |
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