糖尿病専門外来診療所における重症低血糖イベントの実態調査:発生の動向と要因及び誘因に関する検討  [in Japanese] Survey of Severe Hypoglycemic Events in an Outpatient Clinic for Diabetes: A Study of the Occurrence Rate, Causes and Inducements  [in Japanese]

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Abstract

<p>糖尿病診療を専門とする外来診療所において2007年から2015年に発生した重症低血糖の発生動向とその要因及び誘因となった患者行動,発生後の対処情況を調査した.糖尿病通院患者5031名中70名に178件の重症低血糖が発生した(発生率0.8件/100人年).重症低血糖を2回以上経験した患者は37名(52.8 %)であった.要因として,1型糖尿病患者では無自覚性低血糖の既往,2型糖尿病では高齢,インスリン治療,SU薬使用,大血管障害,認知症が示唆された.誘因は食事・活動量の変化によるものが73件(41.0 %),次いで明確な誘因なく発生したものが41件(23.0 %)であった.従来の療養指導に加えて,上記のハイリスク患者をとらえ,誘因となりうる行動への適切な対処を促す援助が重要と考えられる.</p>

<p>We conducted a longitudinal study from 2007-2015 to identify trends in cases of severe hypoglycemia at a Japanese diabetes outpatient clinic using the Computerized Diabetes Care-Metabolic Syndrome (CoDiC-MS<sup>®</sup>) database. There were 178 severe hypoglycemic events in 70 patients during the 9-year study period (0.8 events per 100 person-year). Thirty-seven patients (52.8 %) experienced more than 2 events. Among the 37 patients with type 1 diabetes, 13 (35.1 %) had hypoglycemia unawareness. In the 33 who had type 2 diabetes, an older age, treatment with insulin or sulfonylureas, macrovascular complications and dementia were identified as potential predictors of severe hypoglycemia. Seventy-three events (41.0 %) were caused by daily living changes in the diet or activity habits, and 41 events (23.0 %) were of unknown cause. Our results suggest that preventive behavioral approaches are necessary for high-risk patients, especially for patients with hypoglycemia unawareness.</p>

Journal

  • Journal of the Japan Diabetes Society

    Journal of the Japan Diabetes Society 61(2), 51-58, 2018

    THE JAPAN DIABETES SOCIETY

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