初诊糖尿病患者对初始基础胰岛素治疗的认知及低血糖经历调查分析  

Investigation and analysis on the cognition of initial basal insulin therapy and hypoglycemia experience of newly diagnosed diabetes patients

作　　者：徐京燕 汪慧娟 胡泽富[3] XU Jingyan;WANG Huijuan;HU Zefu(Drug Storage,Quzhou People's Hospital,Quzhou 324000,China;Distribution Center of Intravenous Drugs,Quzhou People's Hospital,Quzhou 324000,China;Department of Personnel,Quzhou People's Hospital,Quzhou 324000,China)

机构地区：[1]衢州市人民医院药库,浙江衢州324000 [2]衢州市人民医院静脉用药调配中心,浙江衢州324000 [3]衢州市人民医院人事科,浙江衢州324000

出　　处：《健康研究》2023年第1期41-45,共5页Health Research

基　　金：衢州市科技计划指导性项目(2019071)。

摘　　要：目的调查初诊糖尿病患者对初始基础胰岛素治疗的认知及低血糖经历,为提升初诊糖尿病患者的相关认知及预防低血糖发生提供参考。方法回顾性分析314例初诊糖尿病患者的临床资料,统计随访期间患者低血糖事件的发生情况以及对初始基础胰岛素治疗的认知水平,单因素分析影响低血糖事件发生的相关因素,多因素Logistic回归分析低血糖事件发生的独立危险因素。结果随访1年内,314例初诊糖尿病患者中有135例发生过749次低血糖事件,总发生率为42.99%;749次低血糖事件中,轻度低血糖占比最高(73.03%),0:00—6:00低血糖事件发生率最高(48.33%)。经历低血糖发生的患者对初始基础胰岛素治疗的认知评分低于无低血糖经历者,差异有统计学意义(P<0.05);单因素分析结果显示,年龄、BMI、文化程度、是否合并高血压、遵医行为、对初始基础胰岛素治疗认知评分与低血糖的发生相关(P<0.05);多因素分析结果显示,年龄≥60岁、BMI<24.0 kg/m 2、遵医行为表现较差、对初始基础胰岛素治疗认知评分<25分是低血糖发生的独立危险因素(P<0.05)。结论初诊糖尿病患者对初始基础胰岛素治疗的认知水平越高,发生低血糖事件的风险越低,应重视夜间低血糖的发生;高龄、低BMI、遵医行为差、治疗认知水平低者易发生低血糖。Objective To investigate the cognition of newly diagnosed diabetes patients on initial basic insulin treatment and their experience of hypoglycemia so as to provide theoretical reference for improving the cognition of newly diagnosed diabetes patients and preventing hypoglycemia.Methods The clinical data of 314 newly diagnosed diabetes patients were retrospectively analyzed.The incidence of hypoglycemia events and the cognition level of initial basic insulin treatment during the follow-up period were statistically analyzed.The related factors influencing the occurrence of hypoglycemia events were analyzed by univariate analysis,and the independent risk factors of hypoglycemia events were analyzed by multivariate logistic regression analysis.Results During the one-year follow-up,135 of 314 newly diagnosed diabetes patients had 749 hypoglycemic events,with a total incidence of 42.99%;Among 749 hypoglycemic events,the proportion of mild hypoglycemia was the highest(73.03%),and the incidence of hypoglycemic events from 0:00 to 6:00 was the highest(48.33%).The cognitive scores of patients who experienced hypoglycemia on initial basic insulin therapy were lower than those without hypoglycemia,and the difference was statistically significant(P<0.05).Univariate analysis showed that age,BMI,education level,hypertension,compliance behavior,and cognitive score of initial basic insulin treatment were associated with hypoglycemia(P<0.05).Multivariate analysis showed that age≥60 years,BMI<24.0 kg/m 2,poor compliance behavior,and cognitive score of initial basic insulin treatment<25 points were independent risk factors for hypoglycemia(P<0.05).Conclusions The higher the cognitive level of newly diagnosed diabetes patients on the initial basic insulin treatment,the lower the risk of hypoglycemic events,and attention should be paid to the occurrence of nocturnal hypoglycemia.The elderly,low BMI,poor compliance behavior,and low treatment cognitive level are prone to hypoglycemia.

关 键 词：初诊糖尿病 初始基础胰岛素治疗 认知水平 低血糖经历 影响因素 

分 类 号：R195.4[医药卫生—卫生统计学]