社区老年2型糖尿病患者严重低血糖的危险因素及对策分析

摘要

Objective To analyze the related risk factors of hypoglycemia in community elderly patients with type 2 diabetes mellitus (T2DM) for exploring the theoretical basis of health education,risk factors and countermeasures in community diabetic patients. Methods One hundred and sixty-three elderly patients with T2DM in Jichuan community of Taixing City from May to July 2015 were selected and divided into the hypoglycemia group(22 cases) and control group(without hypoglycemia oc-currence,141 cases) according to the random sampling method. The cultural level,gender,age,body mass index(BMI) and disease course in these two groups were collected;whether living alone,regular measurement of blood glucose,insulin use and oral hypo-glycemic drug use were recorded. In hypoglycemia occurrence ,whether complicating other diseases was also recorded. The single and multiple factor Logistic regression analysis was performed. Results The gender,age,living alone and disease course were the risk factors of the elderly patients with T2DM(P<0.05);the combined application of hypoglycemic drugs,disease course more than 10 years,insulin use and related diseases were the risk factors of hypoglycemia occurrence (P<0.05). The multivariate Logis-tic regression analysis showed that high BMI(>26 kg/m2),education level(junior high school above) and regular measurement of blood glucose were the protective factors for hypoglycemia (P<0.05). Conclusion There are a lot of risk factors for hypoglycemia in community elderly patients with T2DM. The education should be strengthened and the related strategy should be given for pre-venting the hypoglycemia occurrence in T2DM patients according to the related factors.%目的：分析社区老年2型糖尿病（T2DM）患者低血糖的相关危险因素，探索社区糖尿病患者健康教育理论依据、危险因素及对策。方法选取2015年5~7月江苏省泰兴市济川社区老年T2DM患者163例，采用随机抽样法将其分为低血糖组（22例）与对照组（141例）。根据低血糖的发生情况，收集整理两组患者的文化程度、性别、年龄、体质量指数（BMI）及病程；记录患者是否独居，定期测量血糖及胰岛素、口服降糖药应用情况，发生低血糖时是否合并其他疾病，并进行单因素和多因素logistic回归分析。结果性别、年龄、独居、病程为社区老年T2DM患者危险因素（P<0.05）；联合应用降糖药物、病程超过10年、胰岛素应用及患相关疾病是低血糖发生的危险因素（P<0.05）。多因素logistic回归分析发现，高BMI（>26 kg/m2）、文化程度（初中以上）、定期测量血糖是低血糖的保护因素（P<0.05）。结论社区老年糖尿病患者低血糖危险因素较多，应根据相关因素加强教育并采取相应对策，预防社区老年T2DM患者低血糖的发生。