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Diabetes Care:严重低血糖与2型糖尿病患者跌倒风险

2020-07-03 MedSci原创 MedSci原创

严重的低血糖症与跌倒风险显著相关。在老年人中进行个体化血糖治疗时,应考虑跌倒风险。评估低血糖病史和未来的低血糖风险也可以改善老年糖尿病患者多因素预防跌倒的干预措施。

据推测,低血糖症会增加2型糖尿病老年人的跌倒风险。但是,很少有研究前瞻性地评估严重低血糖与跌倒之间的关联,而跌倒是患者发病率和死亡率的重要原因。

近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,研究人员对在社区动脉粥样硬化风险(ARIC)研究第4次随访(1996-1998年)期间诊断为糖尿病的参与者进行了前瞻性队列分析。根据第九版《国际疾病分类》中住院、急诊就诊和呼叫救护车的代码确定了需要治疗的严重低血糖发作事件。从1996年至2013年,使用E码从医疗索赔中确定了跌倒的总数。次要分析评估了住院跌倒和有骨折的跌倒。研究人员计算了发病率,并使用Cox回归模型评估了严重低血糖与2013年第4次随访后发生跌倒之间的独立关联。

在1162名糖尿病患者中,有149人在基线之前或中位随访时间13.1年内发生严重的低血糖事件。没有严重低血糖症的患者跌倒的发生率是每100人每年2.17人(PY)(95%CI为1.93–2.44),而患有严重低血糖症的患者跌倒的发生率是每100PY(6.73-11.53)。调整后,严重低血糖症患者跌倒的风险增加两倍以上(风险比2.23,95%CI为1.61–3.07)。在由年龄、性别、种族、BMI、糖尿病持续时间或功能障碍定义的亚组中,关联是一致的。

在这个以社区为基础的成年人群中,严重的低血糖症与跌倒风险显著相关。在老年人中进行个体化血糖治疗时,应考虑跌倒风险。评估低血糖病史和未来的低血糖风险也可以改善老年糖尿病患者多因素预防跌倒的干预措施。

原始出处:

Alexandra K. Lee.et al.Severe Hypoglycemia and Risk of Falls in Type 2 Diabetes: The Atherosclerosis Risk in Communities (ARIC) Study.Diabetes Care.2020.https://doi.org/10.2337/dc20-0316

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    2020-12-27 zhouqu_8
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    2020-07-04 misszhang

    谢谢MedSci提供最新的资讯

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