超大粒度高血糖危机期间的低血糖症与长期死亡率有关
Tomás González-Vidal1,2, Carmen Lambert3, Ana Victoria García3
1Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Oviedo, Spain. tomasgonvidal@gmail.com.
Diabetology & metabolic syndrome
|April 9, 2024
概括
超大的高血糖危机期间的低血糖预测糖尿病患者的长期死亡率. 这种风险特别高,当初始静脉注射胰岛素治疗期间出现低血糖时.
科学领域:
- 内分泌学 在内分泌学.
- 代谢障碍 代谢障碍 代谢障碍
- 临床研究 临床研究
背景情况:
- 住院期间的低血糖与糖尿病患者的不良结果有关.
- 对高血糖危机入院患者低血糖症的长期影响的研究有限.
- 超大胞高血糖危机 (HHC) 带来了重大风险,低血糖症可能会加剧这些风险.
研究的目的:
- 为了调查低血糖症对因超大小块高血糖危机住院的成年人长期影响.
- 为了确定HHC期间的低血糖是否与所有原因的死亡率有关.
- 为了区分胰岛素治疗不同阶段低血糖症的预后意义.
主要方法:
- 追溯对象研究,对170名因高血压性肝炎 (包括纯高血压性肝炎和高血压性糖尿病酸性肝炎) 住院的患者进行.
- 在初始静脉注射胰岛素治疗和随后的皮下胰岛素治疗阶段,分析低血糖的发生情况.
- 长期死亡率评估,随访时间中位数为652天.
主要成果:
- 在初始IV胰岛素治疗期间,在26.5%的患者和随后的SC胰岛素治疗期间,在52.7%的患者中观察到低血糖症.
- 这两种低血糖事件都与长期死亡率的增加有关.
- 在调整了混因素后,初始IV胰岛素治疗期间的低血糖仍然是死亡率的显著预测因素 (HR 2.10,p=0.004).
结论:
- 超大的高血糖危机期间的低血糖是长期死亡率的标志物.
- 在初始静脉注射胰岛素治疗阶段出现低血糖症,特别表明长期死亡风险增加.
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