Severe Hypoglycemia(严重低血糖)研究综述
Severe Hypoglycemia 严重低血糖 - 44% times with only one episode of severe hypoglycemia (< 40 mg/dl). [1] There was no ketoacidosis or severe hypoglycemia. [2] No events of severe hypoglycemia occurred. [3] Importance Previous studies have found that the risk of severe hypoglycemia does not differ between long-acting insulin analogs and neutral protamine Hagedorn (NPH) insulin in patients with type 2 diabetes. [4] In addition, diabetic ketoacidosis (DKA) and severe hypoglycemia rates were compared. [5] Indeed, in the ACCORD trial and similar studies, severe hypoglycemia was a particularly significant mortality risk factor. [6] Until now, injectable glucagon was the only available treatment used in the management of severe hypoglycemia wherein glucagon had to be prepared in several steps before administration. [7] In turn, severe hypoglycemia is associated with major adverse cardiovascular events, arrhythmias, and other complications. [8] The prevalence of severe hypoglycemia was lower in people with demonstrable C-peptide versus those with absent C-peptide (30% vs 41%, p=0. [9] Primary outcome was safety: incidences of severe hypoglycemia, diabetic ketoacidosis, time spent in glycemia <54 mg/dl. [10] She had 5 episodes of severe hypoglycemia within the previous 3 months. [11] 85), and showed the reduced trend in the risk of severe hypoglycemia (RR 0. [12] No serious adverse events (including severe hypoglycemia), or discontinuations occurred, and the incidence of treatment-emergent adverse events was similar between treatments. [13] Here, pancreatectomy was performed directly due to severe hypoglycemia. [14] Severe hypoglycemia puts patients at risk of injury and death. [15] Hemoglobin A1c (HbA1c) is used as an index of glycemic control, but strict glycemic control using HbA1c as an index may lead to severe hypoglycemia and cardiovascular death. [16] In the juvenile-onset group, the omission error rate were associated with the history of severe hypoglycemia (β = 0. [17] The present study aimed to determine the relationship between astrocytes and recurrent non-severe hypoglycemia (RH)2 -associated cognitive decline in diabetes. [18] 6% in 2019, but that of patients visiting the emergency room for severe hypoglycemia did not change over time. [19] The majority of patients with T2DM are elderly people and older, forming groups with high comorbidity and the risk of severe hypoglycemia, including those associated with excess hypoglycemic therapy. [20] , <8%) may be warranted for children with a history of severe hypoglycemia, severe morbidities, or short life expectancy. [21] Risk factors for pump abandonment: later age of start treatment on CSII and frequent episodes of severe hypoglycemia. [22] Symptoms of severe hypoglycemia were reported in 2. [23] HbA1c and proportion of patients with diabetic ketoacidosis (DKA) or severe hypoglycemia (SH) were analyzed; linear and logistic regression models adjusted for demographics, region, and gross domestic product per capita were applied. [24] RESULTS If used in the general ward hospital settings, CGM and flash glucose monitoring (FGM) systems could lead to improved glycemic control, decreased length of stay, and reduced risk of severe hypoglycemia or hyperglycemia. [25] However, as demonstrated by Anderson et al4 elsewhere in JAMA Network Open, intensification of glucose-lowering therapy upon hospital discharge does not appear to improve glycemic control but exposes patients to risk of preventable harm due to severe hypoglycemia in the immediate postdischarge period. [26] Dasiglucagon is a novel glucagon analog, stable in aqueous solution and suitable for delivery in a ready-to-use autoinjector (HypoPal®) for the treatment of severe hypoglycemia. [27] So deprescribing in elderly with diabetes should be primarily aimed at minimizing of cardiovascular events and severe hypoglycemia risks. [28] Severe hypoglycemia, in itself, is a risk for patients and relatives. [29] Background: This study aimed to investigate the ability of a deep learning model to predict the outcome of severe hypoglycemia (SH) using longitudinal electronic medical records data. [30] , those who are pregnant or planning pregnancy, or who have hypoglycemia unawareness or a history of severe hypoglycemia) is unknown. [31] We sought to evaluate the prognostic utility of monitoring IAbs in diabetic patients after islet transplantation (ITx); (2) Methods: Twelve patients with Type 1 diabetes mellitus and severe hypoglycemia underwent ITx. [32] A 67-year-old female presented with severe hypoglycemia with a blood glucose of 34 mg/dl five hours after having dinner. [33] 7%, respectively, with no cases of severe hypoglycemia. [34] Other outcomes included incidence of severe hypoglycemia, weight changes, cardiovascular events, and number of injections. [35] There was no significant difference in the frequency of severe hypoglycemia, hypoglycemia awareness, QOL, and depression scores between the two groups. [36] 6% with no episodes of severe hypoglycemia or euglycemic diabetic ketoacidosis. [37] 0 criteria should consider absolute rather than relative levels of insulin use and C-peptide as qualifiers with treatment success based on glucose assessment using CGM-metrics on par with assessment of HbA1c and severe hypoglycemia events. [38] OBJECTIVE Literature suggests that severe hypoglycemia (SH) may be linked to cardiovascular events only in older individuals with high cardiovascular risk score (CV-score). [39] Adverse outcomes including hospitalization, DKA, severe hypoglycemia, or death were reported through medical chart review. [40] Results Among 2,821 older adults (mean age 56 years) with type 1 diabetes, 398 (14%) had a history of severe hypoglycemia, 335 (12%) had severe hyperglycemia, and 87 (3%) had both. [41] Glycemic control was suboptimal; the low incidence of severe hypoglycemia suggests careful glycemic control, balancing benefits and risks, particularly in Japanese adults aged ≥ 65 years with type 1 diabetes. [42] Among those who transitioned within the past two years (N=254), unemployed non-students were significantly more likely to experience diabetic ketoacidosis or severe hypoglycemia than unemployed students (p=0. [43] Thirty years after the tumor discovery, the patient was admitted to the hospital with symptoms of severe hypoglycemia, which was diagnosed as NICTH based on a complete examination. [44] This article reports on a study by the T1D Exchange Quality Improvement Collaborative evaluating differences in A1C, diabetic ketoacidosis (DKA), severe hypoglycemia, and technology use among racial and ethnic groups. [45] OBJECTIVE To estimate the relative and absolute risk of severe hypoglycemia and mortality associated with glucose control, sulfonylureas, and insulin treatment in elderly people with type 2 diabetes. [46] There were no severe hypoglycemia or diabetic ketoacidosis events during the study phase. [47] Blood tests revealed severe metabolic acidosis, coagulopathy, and leukocytosis, followed by severe hypoglycemia and elevated levels of transaminases and ammonia. [48] Suboptimal glycemic control, weight gain, and severe hypoglycemia are areas of unmet clinical need in T1D care. [49] The proportion of subjects with a history of severe hypoglycemia was lower with high (27%) and intermediate (48%) residual C-peptide concentrations than with low (74%) and no (70%) residual C-peptide concentrations (P value for trend = 0. [50]44% 次仅发生一次严重低血糖 (< 40 mg/dl)。 [1] 没有酮症酸中毒或严重低血糖。 [2] 未发生严重低血糖事件。 [3] 重要性 先前的研究发现，长效胰岛素类似物和中性鱼精蛋白 Hagedorn (NPH) 胰岛素在 2 型糖尿病患者中的严重低血糖风险没有差异。 [4] 此外，还比较了糖尿病酮症酸中毒（DKA）和严重低血糖的发生率。 [5] 事实上，在 ACCORD 试验和类似研究中，严重低血糖是一个特别重要的死亡风险因素。 [6] 迄今为止，注射用胰高血糖素是治疗严重低血糖症的唯一可用治疗方法，其中胰高血糖素必须在给药前的几个步骤中制备。 [7] 反过来，严重的低血糖症与主要不良心血管事件、心律失常和其他并发症有关。 [8] 与没有 C 肽的人相比，具有明显 C 肽的人严重低血糖的发生率较低（30% 对 41%，p=0. [9] 主要结果是安全性：严重低血糖、糖尿病酮症酸中毒的发生率，血糖<54 mg/dl的时间。 [10] 在过去的 3 个月内，她有 5 次严重低血糖发作。 [11] 85），并显示出严重低血糖风险的降低趋势（RR 0. [12] 没有发生严重的不良事件（包括严重的低血糖）或停药，并且治疗中出现的不良事件的发生率在治疗之间相似。 [13] 在这里，由于严重的低血糖，直接进行了胰腺切除术。 [14] 严重的低血糖使患者面临受伤和死亡的风险。 [15] 血红蛋白 A1c (HbA1c) 被用作血糖控制的指标，但以 HbA1c 为指标进行严格的血糖控制可能会导致严重的低血糖和心血管死亡。 [16] 在青少年发病组中，遗漏错误率与严重低血糖病史相关（β = 0. [17] 本研究旨在确定星形胶质细胞与复发性非严重低血糖 (RH)2 相关的糖尿病认知下降之间的关系。 [18] 2019 年为 6%，但因严重低血糖而到急诊室就诊的患者比例并未随时间变化。 [19] 大多数 T2DM 患者是老年人和老年人，形成了具有高合并症和严重低血糖风险的群体，包括那些与过度降糖治疗相关的群体。 [20] , <8%) 对于有严重低血糖病史、严重疾病或预期寿命短的儿童可能是有保证的。 [21] 弃泵的风险因素：CSII 开始治疗的年龄较晚和严重低血糖的频繁发作。 [22] 2 报告了严重低血糖的症状。 [23] 分析了 HbA1c 和糖尿病酮症酸中毒 (DKA) 或严重低血糖症 (SH) 患者的比例；应用了根据人口统计、地区和人均国内生产总值调整的线性和逻辑回归模型。 [24] 结果 如果在普通病房医院环境中使用，CGM 和快速血糖监测 (FGM) 系统可以改善血糖控制、缩短住院时间并降低严重低血糖或高血糖的风险。 [25] 然而，正如 Anderson 等人在 JAMA Network Open 中其他地方所证明的那样，出院时强化降糖治疗似乎并不能改善血糖控制，但会使患者在出院后即刻因严重低血糖而面临可预防的伤害风险。 [26] Dasiglucagon 是一种新型胰高血糖素类似物，在水溶液中稳定，适合在即用型自动注射器 (HypoPal®) 中输送，用于治疗严重的低血糖症。 [27] 因此，老年糖尿病患者的处方应主要旨在最大限度地减少心血管事件和严重低血糖风险。 [28] 严重的低血糖症本身就是对患者和亲属的风险。 [29] 背景：本研究旨在调查深度学习模型使用纵向电子病历数据预测严重低血糖（SH）结果的能力。 [30] ，那些正在怀孕或计划怀孕的人，或者那些没有意识到低血糖或有严重低血糖病史的人）是未知的。 [31] 我们试图评估在胰岛移植 (ITx) 后监测 Iabs 在糖尿病患者中的预后效用； (2)方法：12例1型糖尿病合并严重低血糖患者接受了ITx。 [32] 一名 67 岁女性在晚餐后 5 小时出现严重低血糖，血糖为 34 mg/dl。 [33] 分别为 7%，无严重低血糖病例。 [34] 其他结果包括严重低血糖的发生率、体重变化、心血管事件和注射次数。 [35] 两组间严重低血糖发生率、低血糖意识、生活质量和抑郁评分无显着差异。 [36] 6% 没有发生严重低血糖或血糖正常的糖尿病酮症酸中毒。 [37] 0 标准应考虑胰岛素使用和 C 肽的绝对水平而不是相对水平，作为基于使用 CGM 指标的葡萄糖评估与 HbA1c 和严重低血糖事件评估相当的治疗成功的限定符。 [38] 目标文献表明，严重低血糖（SH）可能仅与心血管风险评分（CV-score）高的老年人的心血管事件有关。 [39] 通过病历审查报告了包括住院、DKA、严重低血糖或死亡在内的不良结果。 [40] 结果 在 2821 名 1 型糖尿病老年人（平均年龄 56 岁）中，398 人（14%）有严重低血糖病史，335 人（12%）有严重高血糖，87 人（3%）两者都有。 [41] 血糖控制不理想；严重低血糖的低发生率表明要谨慎控制血糖，平衡收益和风险，特别是在年龄 ≥ 65 岁的 1 型糖尿病日本成年人中。 [42] 在过去两年内过渡的人（N=254）中，失业的非学生比失业的学生更容易出现糖尿病酮症酸中毒或严重的低血糖症（p=0. [43] 肿瘤发现三十年后，患者因严重低血糖症状入院，经全面检查诊断为 NICTH。 [44] 本文报道了 T1D 交换质量改进协作组织的一项研究，该研究评估了种族和族裔群体之间 A1C、糖尿病酮症酸中毒 (DKA)、严重低血糖和技术使用的差异。 [45] 目的 评估老年 2 型糖尿病患者与血糖控制、磺脲类药物和胰岛素治疗相关的严重低血糖和死亡率的相对和绝对风险。 [46] 在研究阶段没有发生严重的低血糖或糖尿病酮症酸中毒事件。 [47] 血液检查显示严重的代谢性酸中毒、凝血功能障碍和白细胞增多，随后出现严重的低血糖以及转氨酶和氨水平升高。 [48] 血糖控制不佳、体重增加和严重低血糖是 T1D 护理中未满足的临床需求领域。 [49] 有严重低血糖病史的受试者比例在高 (27%) 和中等 (48%) 残留 C 肽浓度下低于低 (74%) 和没有 (70%) 残留 C 肽浓度 (P 值对于趋势 = 0。 [50]
body mass index
This study aimed to compare metabolic control measured as hemoglobin A1c (HbA1c), the risk of severe hypoglycemia, and body composition measured as body mass index standard deviation scores (BMI‐SDS) in a nationwide sample of children and adolescents with Type 1 diabetes with continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI), respectively. [1] multiple daily injections (MDI) in children and adolescents with type 1 diabetes mellitus (T1DM) from a public health care system in developed areas of developing country, considering changes in glycemic Control, daily insulin requirements, lipid profile, body mass index (BMI), frequency of severe hypoglycemia and Diabetic Ketoacidosis (DKA) and diabetic complications. [2] Primary risk factors of neurometabolic changes in patients with type 1 diabetes were episodes of severe hypoglycemia in the history of the disease, diabetic ketoacidosis (DKA), chronic hyperglycemia, and increased body mass index (BMI). [3]本研究旨在比较以血红蛋白 A1c (HbA1c) 衡量的代谢控制、严重低血糖风险以及以体重指数标准差评分 (BMI-SDS) 衡量的全国 1 型糖尿病儿童和青少年样本中的身体成分分别为连续皮下胰岛素输注（CSII）和每日多次注射（MDI）。 [1] 考虑到血糖控制、每日胰岛素需求、血脂、体重指数 (BMI) 的变化，发展中国家发达地区的公共卫生保健系统对患有 1 型糖尿病 (T1DM) 的儿童和青少年进行每日多次注射 (MDI) ，严重低血糖和糖尿病酮症酸中毒（DKA）和糖尿病并发症的频率。 [2] nan [3]
No Severe Hypoglycemia
No severe hypoglycemia occurred in either group during the trial. [1] No severe hypoglycemia events occurred during the control period, whereas one severe hypoglycemic event occurred during the closed-loop period, but not during closed-loop operation. [2] No severe hypoglycemia (level 3) was reported in this study. [3] No severe hypoglycemia and no rebound hyperglycemia occurred in neither group. [4] No severe hypoglycemia was observed in both groups. [5] No severe hypoglycemia events were reported. [6]试验期间，两组均未发生严重低血糖。 [1] 在控制期间没有发生严重低血糖事件，而在闭环期间发生了1次严重低血糖事件，但在闭环操作期间没有发生。 [2] nan [3] nan [4] nan [5] nan [6]
Experiencing Severe Hypoglycemia
Compared with second-generation basal insulins, low to high certainty evidence suggested that NPH was associated with a higher risk of patients experiencing severe hypoglycemia; NPH and first-generation basal insulins were associated with a higher rate of nocturnal confirmed hypoglycemic events. [1] Age, level of education, and average monthly income were significantly associated with experiencing severe hypoglycemia (p = 0. [2] This abstract is the first description of a patient without diabetes mellitus experiencing severe hypoglycemia induced by the ARB, Losartan. [3] 0% reported experiencing severe hypoglycemia, defined as a change in mental and/or physical functioning and needing help from another person, while 6. [4] It is reported that a six-fold increase in deaths due to diabetes has been attributed to patients experiencing severe hypoglycemia in comparison to those not experiencing severe hypoglycemia. [5] Compared with second-generation basal insulins, low to high certainty evidence suggested that NPH was associated with a higher risk of patients experiencing severe hypoglycemia; NPH and first-generation basal insulins were associated with a higher rate of nocturnal confirmed hypoglycemic events. [6]与第二代基础胰岛素相比，从低到高确定性的证据表明，NPH 与患者出现严重低血糖的风险较高有关； NPH 和第一代基础胰岛素与较高的夜间确诊低血糖事件发生率相关。 [1] 年龄、教育水平和平均月收入与严重低血糖显着相关（p = 0. [2] nan [3] nan [4] nan [5] nan [6]
Without Severe Hypoglycemia
One patient (20%) became insulin independent from the second postoperative month, whereas the remaining four patients required insulin; C-peptide was present in the blood in all cases and good glycemic control was possible without severe hypoglycemia (Table 1). [1] Virtual pump training program for novel devices in people with type 1 diabetes on multiple daily injections can be an effective tool to initiate an advanced HCL system (MiniMed 780G) and to improve glycemic control in a safe manner without severe hypoglycemia and hyperglycemia. [2] 0% without severe hypoglycemia. [3]一名患者（20%）从术后第二个月开始不再依赖胰岛素，而其余四名患者需要胰岛素；在所有病例中，C 肽都存在于血液中，并且可以在没有严重低血糖的情况下实现良好的血糖控制（表 1）。 [1] 1 型糖尿病患者每日多次注射新型设备的虚拟泵培训计划可以成为启动高级 HCL 系统 (MiniMed 780G) 并以安全方式改善血糖控制而不会出现严重低血糖和高血糖的有效工具。 [2] nan [3]
Recurrent Severe Hypoglycemia
A 69-year-old female patient was referred to the Medical University of Hanover for further diagnostic evaluation of recurrent severe hypoglycemia. [1] The patient received sensor-augmented pump therapy with the predictive low glucose management system to prevent recurrent severe hypoglycemia. [2] The UK islet allotransplant program is nationally funded to deliver 1 or 2 transplants over 12 months to individuals with type 1 diabetes and recurrent severe hypoglycemia. [3]一名 69 岁的女性患者被转诊至汉诺威医科大学，以对复发性严重低血糖进行进一步的诊断评估。 [1] 患者接受了传感器增强泵治疗和预测性低血糖管理系统，以防止复发性严重低血糖。 [2] nan [3]
Cause Severe Hypoglycemia
Additionally, I identified risks that the included medicines may carry for diabetes patients, such as interactions between warfarin and sulfonylureas that may cause severe hypoglycemia or potentiation of gastrointestinal side effects with co-administration of opioids and various hypoglycemics. [1] The insulin tolerance test (ITT) is considered the reference standard GHST but is labor intensive, can cause severe hypoglycemia, and is contraindicated for certain patients. [2]Treating Severe Hypoglycemia
Glucagon administration is an effective way of treating severe hypoglycemia, especially in a free-living setting. [1] It is known that glucagon is an effective therapy for treating severe hypoglycemia, but its short half-life prevents its wide therapeutic use. [2]胰高血糖素给药是治疗严重低血糖的有效方法，尤其是在自由生活环境中。 [1] 众所周知，胰高血糖素是治疗严重低血糖的有效疗法，但其短半衰期阻碍了其广泛的治疗用途。 [2]
Experienced Severe Hypoglycemia
Immediately following the procedure, the patient experienced severe hypoglycemia, which has not previously been reported as a complication of CPN. [1] Conclusion: Sulfonylurea-treated T2D patients who experienced severe hypoglycemia are at increased risk of future hypoglycemia episodes. [2]手术后，患者立即出现了严重的低血糖，这在以前没有被报道为 CPN 的并发症。 [1] 结论：经磺脲类药物治疗的 T2D 患者出现严重低血糖，未来低血糖发作的风险增加。 [2]
Developed Severe Hypoglycemia
Their patient developed severe hypoglycemia requiring intravenous dextrose. [1] She developed severe hypoglycemia, which was confirmed on a venous BG, and her condition was complicated by an apparent stroke-like state. [2]他们的病人出现了严重的低血糖，需要静脉注射葡萄糖。 [1] 她出现了严重的低血糖症，这在静脉 BG 上得到证实，并且她的病情因明显的中风样状态而变得复杂。 [2]
severe hypoglycemia event
0 criteria should consider absolute rather than relative levels of insulin use and C-peptide as qualifiers with treatment success based on glucose assessment using CGM-metrics on par with assessment of HbA1c and severe hypoglycemia events. [1] No severe hypoglycemia events occurred during the control period, whereas one severe hypoglycemic event occurred during the closed-loop period, but not during closed-loop operation. [2] There were no severe hypoglycemia events (glucose level <3. [3] There were no severe hypoglycemia events and drug related serious adverse events. [4] There were no severe hypoglycemia events (glucose level <3. [5] In some instances, recovery from a severe hypoglycemia event may require health care resource utilization (HCRU), including the use of emergency medical services (EMS), visits to the emergency department (ED), and inpatient hospitalization. [6] 2% of participants experienced a symptomatic episode of hypoglycemia (nocturnal or severe hypoglycemia events were infrequent). [7] 001)] of the patients [66(28) days], with no severe hypoglycemia events. [8] The analysis included glucose monitoring device costs, cost savings due to reductions in glycated hemoglobin, severe hypoglycemia events, and hyperglycemic emergencies such as diabetic ketoacidosis. [9] No severe hypoglycemia events were reported. [10]0 标准应考虑胰岛素使用和 C 肽的绝对水平而不是相对水平，作为基于使用 CGM 指标的葡萄糖评估与 HbA1c 和严重低血糖事件评估相当的治疗成功的限定符。 [1] 在控制期间没有发生严重低血糖事件，而在闭环期间发生了1次严重低血糖事件，但在闭环操作期间没有发生。 [2] nan [3] nan [4] nan [5] nan [6] nan [7] nan [8] nan [9] nan [10]
severe hypoglycemia occurred
No events of severe hypoglycemia occurred. [1] No severe hypoglycemia occurred in either group during the trial. [2] No episodes of diabetic ketoacidosis or severe hypoglycemia occurred in either cohort. [3] Results Severe hypoglycemia occurred more often in the cold season than in the warm season. [4]未发生严重低血糖事件。 [1] 试验期间，两组均未发生严重低血糖。 [2] nan [3] nan [4]