HYPOGLYCEMIA IN ELDERLY TYPE 2 DIABETES PATIENTS WITH EGFR < 60 ML/MIN/M2 AT HANOI NATIONAL OF ENDOCRINOLOGY HOSPITAL

Thị Lựu Nguyễn, Hoàng Hiệp Phan

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Abstract

Ojectives: To describe the clincal and paraclinicalCharacteristics of hypoglycemia in type 2 diabetes mellitus patients with eGFR< 60 ml/min/m2. Subjects and method: In this cross sectional analytical study a total of 126 elderly type 2 diabetes mellitus patients with eGFR< 60 ml/min/m2 who hospitalized for hypoglycemia or hypolycemia during hospitalization at Hanoi national of endrocrinology hospital. Results: Mean age 71.1± 7.3; the rate of patients who had duration time of type 2 diabetes mellitus over 15 years was 63.5%; 25.4% severe hypoglycemia; the percentage of elderly diabetes patients who had eGFR under 30 ml/min/m2 was 40,5%; 52.4% patients had glucose under 3.0 mmol/l; 38,6% asymptomtomatic hypoglycemia. Common ASD symptoms were sweaty, hungry and tremors respectively 44.8%, 52.3% and 55.6%. Symptoms of CNS are quite slight such as fatigue (24.4%), dizziness (24.4%), blurred vision (25.2%). Conclusion: Hypoglycemia in elderly type 2 diabetes patients with eGFR < 60 ml/min/m2 is common asymptomatic. Common ASD symptoms are sweaty, hungry and tremors respectively.

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References

1. Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012. JAMA. 2015;314(10):1021-1029. doi:10.1001/jama.2015.10029
2. Alsahli M, Gerich JE. Hypoglycemia, Chronic Kidney Disease, and Diabetes Mellitus. Mayo Clinic Proceedings. 2014; 89(11): 1564-1571. doi:10. 1016/j.mayocp.2014.07.013
3. Moen MF, Zhan M, Hsu VD, et al. Frequency of Hypoglycemia and Its Significance in Chronic Kidney Disease. Clin J Am Soc Nephrol. 2009;4(6):1121-1127. doi:10.2215/CJN.00800209
4. Zoungas S, Patel A, Chalmers J, et al. Severe hypoglycemia and risks of vascular events and death. N Engl J Med. 2010;363(15):1410-1418. doi:10.1056/NEJMoa1003795
5. Boer IH de, Caramori ML, Chan JCN, et al. KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney International. 2020;98(4):S1-S115. doi:10. 1016/j.kint.2020.06.019
6. Association AD. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2021. Diabetes Care. 2021;44 (Supplement 1):S15-S33. doi:10.2337/dc21-S002
7. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). The Lancet. 1998;352 (9131): 837-853. doi:10.1016/S0140-6736 (98) 07019-6
8. Lê thị Pương Huệ. Khảo sát tình trạng hạ đường huyết và các yếu tố liên quan ở bệnh nhân đái đường týp 2 có giảm mức lọc cầu thận < 60ml/phút. Luận văn chuyên khoa cấp II. Đại học Y Hà Nội; 2019.
9. Ahmad I, Zelnick LR, Batacchi Z, et al. Hypoglycemia in People with Type 2 Diabetes and CKD. Clin J Am Soc Nephrol. 2019;14(6):844-853. doi:10.2215/CJN.11650918
10. Cardona S, Gomez PC, Vellanki P, et al. Clinical characteristics and outcomes of symptomatic and asymptomatic hypoglycemia in hospitalized patients with diabetes. BMJ Open Diabetes Res Care. 2018;6(1): e000607. doi:10. 1136/bmjdrc-2018-000607