摘要
背景低血糖恐惧感(FOH)是影响糖尿病患者血糖控制达标的重要因素,老年糖尿病患者由于对低血糖敏感性和反应能力降低而更易出现低血糖,但目前国内研究多侧重于老年糖尿病患者低血糖发生原因及影响因素,对FOH的研究报道较少见。目的分析老年糖尿病患者FOH发生情况及其影响因素。方法采用便利抽样方法,选取2019年3—9月在天津医科大学朱宪彝纪念医院就诊的老年糖尿病患者(≥60岁)720例,采用自行设计的《一般资料调查表》、中文版低血糖恐惧调查表-忧虑量表(CHFSII-WS)、Gold's法、糖尿病自我管理行为量表(SDSCA)进行问卷调查,分析其FOH、低血糖感知受损(IAH)发生情况;老年糖尿病患者发生FOH的影响因素分析采用二元Logistic回归分析(后退法)。结果共发放问卷720份,回收有效问卷690份,问卷有效回收率为95.8%(690/720)。690例患者中有FOH者309例(44.8%),有IAH者71例(10.3%)。二元Logistic回归分析结果显示,低血糖类型〔无症状性:OR=5.627,95%CI(1.133,27.949),P=0.035;可疑症状性:OR=3.034,95%CI(1.245,7.394),P=0.015;症状性:OR=4.444,95%CI(1.793,11.017),P=0.001;严重低血糖:OR=22.414,95%CI(4.099,122.554),P=0.000〕、低血糖预防教育〔OR=2.203,95%CI(1.386,3.502),P=0.001〕是老年糖尿病患者发生FOH的影响因素。结论老年糖尿病患者FOH发生率较高(44.8%),而低血糖类型、低血糖预防教育是老年糖尿病患者发生FOH的影响因素,医务工作者在加强老年糖尿病患者低血糖预防教育、提高患者低血糖风险意识的同时还需注意对其心理状态和IAH进行评估,以减少低血糖及FOH的发生。
Background Fear of hypoglycemia(FOH)is an important factor associated with reaching the glycemic control targets.Elderly diabetic patients are more prone to hypoglycemia due to decreased sensitivity and response to hypoglycemia.In China,most relevant studies have placed emphasis on the reasons and influencing factors of hypoglycemia in elderly diabetics,but few have studied FOH in this population.Objective To explore the prevalence and influencing factors of FOH in elderly diabetic patients.Methods A total of 720 elderly diabetic patients(≥60 years old)were selected from Tianjin Medical University Chu Hsien-I Memorial Hospital from March to September 2019 by using convenient sampling.A self-designed Sociodemographic Questionnaire,the Chinese version of CHFSII-WS,Gold's method and Summary of Diabetes Self-Care Activities(SDSCA)were used to carry out the questionnaire survey to collect relevant information.The prevalence of FOH and impaired awareness of hypoglycemia(IAH)was analyzed,respectively.Backward binary Logistic regression analysis was used to identify the influencing factors of FOH.Results The survey received a response rate of 95.8%(690/720).Of the 690 respondents,309(44.8%)had FOH,and 71(10.3%)had IAH.Backward binary Logistic regression analysis results showed that,FOH was significantly correlated with previous hypoglycemic types〔asymptomatic:OR=5.627,95%CI(1.133,27.949),P=0.035;suspicious symptomatic:OR=3.304,95%CI(1.245,7.394),P=0.015;symptomatic:OR=4.444,95%CI(1.793,11.017),P=0.001;severe hypoglycemia:OR=22.414,95%CI(4.099,122.554),P=0.001〕and hypoglycemic prevention education〔OR=2.203,95%CI(1.386,3.502),P=0.001〕.Conclusion The prevalence of FOH is as high as 44.8%in elderly diabetic patients,which is associated with hypoglycemic types,hypoglycemic prevention education.In view of this,medical workers should pay more attention to the assessment of mental state and IAH during strengthening the hypoglycemia prevention education and improving the awareness of hypoglycemia risk,to reduce the inci
作者
包頔
余杭青
程正楠
许洪梅
王青龙
邢秋玲
BAO Di;YU Hangqing;CHENG Zhengnan;XU Hongmei;WANG Qinglong;XING Qiuling(Tianjin Medical University Chu Hsien-I Memorial Hospital/Tianjin Institute of Endocrinology/NHC Key Laboratory of Hormones and Development/Tianjin Key Laboratory of Metabolic Diseases,Tianjin 300134,China;Tianjin Medical University,Tianjin 300070,China)
出处
《中国全科医学》
CAS
北大核心
2020年第30期3775-3780,共6页
Chinese General Practice
基金
天津市科技计划项目(18ZXZNSY00280):基于大数据和人工智能的糖尿病临床辅助分析与管理系统的研发和应用研究。
关键词
糖尿病
2型
老年人
低血糖症
低血糖恐惧感
低血糖感知受损
自我管理行为
横断面研究
影响因素分析
Diabetes mellitus
type 2
Aged
Hypoglycemia
Fear of hypoglycaemia
Impaired awareness of hypoglycaemia
Self-management behavior
Cross-sectional studies
Root cause analysis
