2型糖尿病并发低血糖昏迷患者的血糖控制应个体化

目的 探讨我院近3年来20例2型糖尿病低血糖昏迷患者的临床特点和预防措施.方法 针对我院急诊收治的低血糖昏迷患者的发病年龄、临床表现、降糖药物选用方式、发病时间、糖化血红蛋白(HbA1c)等临床资料进行分析,同时根据年龄分成两组:≥65岁组(13例)和＜65岁组(7例),从中找到引起低血糖昏迷的常见原因,由此探讨预防的措施.结果 我院低血糖昏迷主要发生在高龄糖尿病患者中；与口服磺脲类长效降糖药物和注射预混胰岛素有关；糖尿病患者的低血糖昏迷发作时间以夜间为主,且与HbA1c较低有关；与＜65岁组相比,≥65岁组患者有更低的HbA1 c(5.4±1.2)％vs(7.3±1.6)％(P＜0.01),发作时更低血糖(1.58±0.59) mmol/L vs (2.39±0.67)mmol/L(P＜0.05)和更长的病程(10.7±3.2)年vs (6.2±2.4)年(P＜0.05).结论 2型糖尿病并发低血糖昏迷患者的血糖控制宜个体化.

Individualization in blood glucose control to patients with type 2 diabetes mellitus accompanied by hypoglycemic coma

Objective To explore the clinical features and prevention of 20 patients with type 2 diabetes mellitus presenting hypoglycemic coma in recently three years in our hospital.Methods Analysis was conducted on the clinical data of the patients with hypoglycemic coma,such as onset age,clinical manifestations,glucose-lowering drugs,attack time and HbA1c,and all patients were divided into two groups according to age：≥65 years old group（13 cases） and 65 years old group（7 cases）,we tried to find the common causes of the hypoglycemic coma and discuss the prevention measures.Results The patients with hypoglycemic coma in our hospital mainly occurred in the elderly patients.The occurrence of hypoglycemic coma was related with the application of long-acting sulphonylurea and premixed insulin,mainly at night.Compared with 65 years old group,patients in ≥65 years old group had lower HbA1c（5.4±1.2）% vs（7.3±1.6）%（P0.01）,value in hypoglycemic coma（1.58±0.59）mmol/L vs（2.39±0.67） mmol/L（P0.05） and a longer course of disease（10.7±3.2）years vs（6.2±2.4） years（P0.05）.Conclusion The control of blood glucose in patients with diabetes mellitus accompanied by hypoglycemic coma should be individualized.