オカダ ヨウスケ   Okada Yosuke
  岡田 洋右
   所属   医学部医学科  臨床医学系 第1内科学
   職種   准教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Hypoglycemia in blood glucose level in type 2 diabetic Japanese patients by continuous glucose monitoring.
掲載誌名 正式名:Diabetology & metabolic syndrome
略  称:Diabetol Metab Syndr
ISSNコード:17585996/17585996
巻・号・頁 11,18頁
著者・共著者 Hajime Maiko, Okada Yosuke, Mori Hiroko, Uemura Fumi, Sonoda Satomi, Tanaka Kenichi, Kurozumi Akira, Narisawa Manabu, Torimoto Keiichi, Tanaka Yoshiya
発行年月 2019/02
概要 Background:Hypoglycemia is associated with cardiovascular diseases, increased risk of death. Therefore, it is important to avoid hypoglycemia. The aim of this study was to characterize hypoglycemia according to glycated hemoglobin (HbA1c) level and determine the contributing factors in type 2 diabetes mellitus (T2DM), using continuous glucose monitoring (CGM).Methods:T2DM patients (n = 293) receiving inpatient care were divided into five groups according to HbA1c level on admission (Group 1: ≥ 6 to < 7%, Group 2: ≥ 7 to < 8%, Group 3: ≥ 8 to < 9%, Group 4: ≥ 9 to < 10%, and Group 5: ≥ 10%). The frequency of hypoglycemia and factors associated with hypoglycemia were analyzed.Results:Hypoglycemia occurred in 15 patients (5.1%), including 4 (8%), 4 (6%), and 7 (10%) patients of Groups 1, 2, and 3, respectively, but in none of groups 4 and 5. Patients with hypoglycemia of Groups 1 had low insulin secretion and were high among insulin users, those of Groups 2 had low homeostasis model assessment of insulin resistance (HOMA-IR). Those of Group 2 and 3 had significantly lower mean blood glucose levels, those of Group 3 only had significantly lower maximum blood glucose level and percentage of AUC > 180 mg/dL. In any of the HbA1c groups, variations in blood glucose level were significantly larger in patients with hypoglycemia than without.Conclusions:Hypoglycemia occurred in patients with a wide range of HbA1c on admission (range 6-9%), suggesting that prediction of hypoglycemia based on HbA1c alone is inappropriate. Among patients with low HbA1c, strict control sometimes induce hypoglycemia. Among patients with high HbA1c, the possibility of hypoglycemia should be considered if there is a marked discrepancy between HbA1c and randomly measured blood glucose level. Larger variations in blood glucose level induce hypoglycemia in any of the HbA1c groups. The treatment to reduce variations in blood glucose level is importan
DOI 10.1186/s13098-019-0412-3
PMID 30815039