低血糖
医学
糖尿病
1型糖尿病
四分位间距
内科学
2型糖尿病
胰岛素
入射(几何)
夜行的
儿科
内分泌学
光学
物理
作者
Nelly Mauras,Dongyuan Xing,Roy W. Beck,William V. Tamborlane,Rosanna Fiallo-Scharer,Irl B. Hirsch,Craig Kollman,Lori M. Laffel,Joyce M. Lee,Katrina J. Ruedy,Eva Tsalikian,Darrell M. Wilson
出处
期刊:Diabetes Care
[American Diabetes Association]
日期:2010-03-03
卷期号:33 (5): 1004-1008
被引量:149
摘要
OBJECTIVE To characterize the amount of nocturnal hypoglycemia and evaluate factors associated with nocturnal hypoglycemia assessed with continuous glucose monitoring (CGM) in adults and children with type 1 diabetes who participated in the Juvenile Diabetes Research Foundation CGM randomized clinical trial. RESEARCH DESIGN AND METHODS The analysis included 36,467 nights with ≥4 h of CGM glucose readings between 12 midnight and 6:00 a.m. from 176 subjects assigned to the CGM group of the trial. The percentage of nights in which hypoglycemia occurred (two consecutive CGM readings ≤60 mg/dl in 20 min) was computed for each subject. Associations with baseline characteristics and clinical factors were evaluated using a multivariate regression model. RESULTS Hypoglycemic events occurred during 8.5% of nights, with the median percentage of nights with hypoglycemia per subject being 7.4% (interquartile range 3.7–12.1%). The duration of hypoglycemia was ≥2 h on 23% of nights with hypoglycemia. In a multivariate model, a higher incidence of nocturnal hypoglycemia was associated with 1) lower baseline A1C levels (P < 0.001) and 2) the occurrence of hypoglycemia on one or more nights during baseline blinded CGM (P < 0.001). The hypoglycemia frequency was not associated with age or with insulin modality (pump versus multiple daily injections). CONCLUSIONS Nocturnal hypoglycemia is frequent and often prolonged in adults and children with type 1 diabetes. Patients with low A1C levels are at an increased risk for its occurrence. One week of blinded CGM can identify patients who are at greater risk for nocturnal hypoglycemia.
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