Clinical Characteristics And Related Risk Factors Of Hypoglycemia In Elderly Diabetic Patients

Objectives:The clinical data of elderly patients with diabetes mellitus(Elderly diabete s)were analyzed,and the clinical characteristics and related risk factors of hypoglycemia were summarized in order to provide some references for early clinical identification and prevention of hypoglycemia in this population.Method:The clinical data(hypoglycemia data,diabetes types,general conditions,laboratory examination indicators,complicated diseases,hypoglycemic drug use,and Mickey's dynamic blood glucose indicators)of 117 diabetic patients hospitalized in the Department of Geriatric Endocrinology,First Affiliated Hospital of Kunming Medical University from August 2018 to September 2019 were retros pectively analyzed.They were divided into senile diabetes group(66 cases,Among them,63 cases of type 2 diabetes mellitus and 3 cases of type 1 diabet esmellitus)and 51 cases of non-elderly diabetes mellitus(including 46 cases of type 2 diabetes mellitus,4 cases of type 1 diabetes mellitus and 1 case of secondary diabetes mellitus),taking blood glucose ?3.9mmol/L as the hypoglycemia standard,the hypoglycemia incidence of fingertip+fasting venous blood glucose and Mickey's dynamic blood glucose of the two groups were calculated respectively,and the characteristics of hypoglycemia were analyzed according to the fixed fingertip blood glucose.The incidence of hypoglycemia of the above diabetes types was calculated based on whether Mikey dynamically monitored hypoglycemia,and then the elderly hypoglycemia group(observation group,30cases)and non-hypoglycemia group(control group,36 cases),non-elderly hypoglycemia group(observation group,27 cases)and non-hypoglycemia group(control group,24 cases)were set up respectively,and the risk factors of hypoglycemia of elderly and non-elderly patients were analyzed by univariate statistics.Finally,the clinical characteristics and related risk factors of hypoglycemia in elderly diabetic patients were compared and summarized.Results:1.the incidence of hypoglycemia1)Fingertip+vein fasting blood glucose measurement:The total hypoglycemia incidence rate was 28.20%,25.75%in elderly diabetic group and 33.33%in non-elderly group.2)Metch's dynamic blood glucose monitoring:the total hypoglycemia incidence rate was 48.71%,45.45%in elderly diabetic group and 52.94%in non-elderly group.3)Determination of blood glucose at fixed-point fingertips(excluding 3AM):4 people had hypoglycemia before breakfast for 6 times in the elderly group,and 5 people had hypoglycemia for 7 times at other time points,accounting for46.15% and 53.84% of the total hypoglycemia times in the elderly group in turn;4 non-elderly people had hypoglycemia 8 times before breakfast,and 10 pe ople had hypoglycemia 22 times at other time points,which accounted for 26.66%and 73.33% of the total hypoglycemia times in the non-elderly group in turn.4)Diabetes classification:According to the results of Miqi dynamic blood glucose monitoring,there are 109 people with type 2 diabetes,and the total incidence of hypoglycemia is 44.95%;There were 7 people with type 1 diabetes,and the total incidence of hypoglycemia was 100%.Among them,there were 63 people with type 2 diabetes and 3 people with type 1 diabetes in the elderly group,and the incidence of hypoglycemia of the two types was 42.85% and 100%respectively;There were 46 patients with type 2 diabetes and 4 patients with type 1 diabetes in the non-elderly group.The incidence of hypoglycemia ofthe two types was 47.82%and 100% respectively.2.General situationElderly observation group and control group:there was no significant difference in general condition between the two groups(p<0.05);non-elderly observation group and control group:there was significant difference in body mass index between the two groups(p<0.05).3.Laboratory inspection indicatorsElderly observation group and control group:There were significant differencesin HbAlc,C peptide,LDL-L and blood potassium between the two groups(P<0.05).Non-elderly observation group and control group:There were significant differences in C peptide,total cholesterol,LDL-L and albumin between the two groups(p<0.05).4.Combined diseasesSenile observation group and control group:There were significant differences in SAHS,water and electrolyte disturbance and cerebral infarction between the two groups(P<0.05).Non-elderly observation group and control group:There was no significant difference between the two groups(p>0.05).5.Use of hypoglycemic drugsSenile observation group and control group:There were significant differences in sulfonylureas,insulin use,short+long-acting insulin,hypoglycemic agents+insulin,and insulin frequency/day between the two groups(P<0.05).Non-elderly observation group and control group:The difference in insulin use between the two groups was statistically significant(p<0.05).6.Mickey's dynamic blood glucose monitoring indicatorsSenile observation group and control group:The differences in SDBG,MAGE and LAGE between the two groups were statistically significant(P<0.05).Non-elderly observation group and control group:The differences in SDBG,MAGE,LAGE and MODD between the two groups were statistically sinificant(p<0.05).Conclusions:1.The incidence of hypoglycemia in diabetic inpatients is high,which can bed etected as early as possible by using dynamic blood glucose monitoring2 Elderly diabetic inpatients are more likely to have hypoglycemia before brea kfast.3 High HbA1C level,poor islet function and hypokalemia are the risk factors of hypoglycemia in elderly diabetic inpatients.4 The history of cerebral infarction,SAHS,water and electrolyte disturbance are the risk factors of hypoglycemia in elderly diabetic inpatients.5 Elderly diabetic inpatients are more susceptible to hypoglycemia due to the influence of hypoglycemic treatment factors.6 The fluctuation of blood glucose is a risk factor for hypoglycemia in diabetic patients,and MAGE has a good predictive value for hypoglycemia.