Fasting Hypoglycemia In Patients With Type 2 Diabetes Mellitus And Analysis Of The Influencing Factors Of Glomerular Filtration Rate

Objective: To investigate the incidence of fasting hypoglycemia(FBG ? 3.9mmol / L)and the influencing factors of glomerular filtration rate(e GFR)in patients with type 2 diabetes mellitus(T2DM).Methods: The data of hospitalized diabetic patients from January 1,2016 to December 31,2016 in Affiliated Hospital of Qingdao University were collected through database.Among them,1134 patients with good fasting blood glucose control,890 patients with mild fasting hypoglycemia and 96 patients with severe fasting hypoglycemia,respectively.The length of stay,cost,death and discharge department were analyzed.In addition,T2 DM patients aged 65 years and over who were hospitalized in our hospital from January 1,2012 to July 31,2018 were selected to analyze the incidence of hypoglycemia in patients with different insulin types,and explore the influencing factors of glomerular filtration rate.Results:(1)the hospitalization days and mortality of patients with mild and severe fasting hypoglycemia were higher than those of patients with normal blood glucose,and the hospitalization expenses of patients with mild fasting hypoglycemia were higher than those of patients with normal blood glucose,the difference was statistically significant(P < 0.05).(2)The incidence of fasting hypoglycemia in non insulin group was higher than that in insulin group(P<0.05),stratified by age,the difference was statistically significant(P < 0.05);the incidence of fasting hypoglycemia in premixed insulin group was higher than that in long-acting insulin group(P = 0.001),stratified by age,the difference was statistically significant(P < 0.05).(3)Grouping by creatinine(Scr):The age,hospitalization days,systolic blood pressure,diastolic blood pressure,smoking,BUN,UA,TG,LP(a)of the abnormal creatinine group were higher than those of the normal creatinine group(P < 0.05),while Hb A1 c,HDL-C and e GFR were lower than those of the normal creatinine group(P < 0.05).(4)Group according to e GFR level(e GFR ? 60 ml / min / 1.73m2 is group A,30 ml / min /m2 ? e GFR < 60 ml / min / m2 is group B,e GFR < 30 ml / min / m2 is group C): the hospitalization days,systolic blood pressure,UA,TG,TC,LP(a),BUN,Scr of group C are higher than those of group A and group B(P < 0.05);fasting blood glucose of group C is lower than that of group B(P < 0.05);Hb A1 c of group C is lower than that of group A and group B(P < 0.05);HDL-C in group A was higher than that in group B and C(P < 0.05);LDL-C in group C was higher than that in group B(P < 0.05).(5)Logistic regression analysis of e GFR: Age,TC,UA,LP(a)were independent risk factors of the decline of e GFR in the elderly patients with type 2 diabetes.Conclusion: 1.The length of stay,cost and mortality of diabetic patients with hypoglycemia in general hospital are significantly increased,most of them are in non endocrine department,and most of them are elderly patients;2.The incidence of fasting hypoglycemia with premixed insulin is higher in T2 DM patients aged 75 and over;3.Age,TC,UA,LP(a)were independent risk factors of the decline of e GFR in the elderly patients with type 2 diabetes.