Jama sub -magazine: I found “excessive” insulin after hypoglycemia?Have you grasped the degree of “treatment and reinforcement”?
Compared with young people, the risk of hypoglycemia in the elderly with diabetes is higher. This higher risk may lead to serious incidence and mortality. The occurrence of hypoglycemia in the elderly is usually related to excessive enhanced diabetes treatment schemes, especially for the elderly who receive sulfonyl drugs, Gleena and insulin therapy. So, after severe hypoglycemia, what is the incidence of de -enhancement of the elderly or insulin treatment?
This retrospective queue includes a random sample of 20%of American medical insurance beneficiaries from January 1, 2007 to December 31, 2017, including medical insurance A and B. Part D. Including at least one patient with low blood sugar -related emergency (ED) or hospitalized diabetes patients. The data analysis time is from August 1, 2020 to August 1, 2021.
The results showed that among 76278 beneficiaries with different medical insurance beneficiaries with hypoglycemia -related EDs or hospitalization, the average (SD) age is 76.6 (7.6). A total of 32074 (30.2%) of patients taking sulfurbin drugs, 60,350 low blood glucose (56.8%) of patients with insulin, and a total of 13,869 (13.0%of patients with sulfa drugs and insulin at the same time (13.0% To.
Among individuals who receive sulfurbal drugs and insulin therapy at the same time during hypoglycemia, the treatment is the highest, followed by individuals who only receive sulfurbaine drugs and insulin therapy. Between 2007 and 2017, the treatment rate of treatment increased. Regardless of the baseline hypoglycemic solution, the lower socio -economic status is related to the lower probability of strengthening the reinforcement. Many patient factors are related to higher treatment: weak, chronic kidney disease, history of falling, and depression.
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In this queue study, an elderly diabetes patients with hypoglycemia -related ED consultations or insulin therapy occurred in less than 50%of the treatment of sulfonyl crickets and/or insulin. However, these non -insulfuration rates may increase over time and may be underestimated. These results show that according to the current evidence, greater efforts need to be made to determine individuals with high blood sugar and high risk to encourage appropriate treatment and strengthen.
参考文献：Anna R. Kahkoska， Virginia Pate， et al. Deintensification of Treatment With Sulfonylurea and Insulin After Severe Hypoglycemia Among Older Adults With Diabetes Anastasia-Stefania Alexopoulos， JAMA Netw Open. 2021;4(11)：e2132215. doi：10.1001 /jamnetworkOpen.2021.32215
