环境温度与美国和台湾使用胰岛素的老年糖尿病患者发生严重低血糖的风险:一项跨国病例交叉研究

IF 14.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes Care Pub Date : 2023-12-07 DOI:10.2337/dc23-1189
Aayush Visaria, Shu-Ping Huang, Chien-Chou Su, David Robinson, John Read, Chuan-Yao Lin, Rachel Nethery, Kevin Josey, Poonam Gandhi, Benjamin Bates, Melanie Rua, Ashwagosha Parthasarathi, Arnab K. Ghosh, Yea-Huei Kao Yang, Soko Setoguchi
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引用次数: 0

摘要

目的 探讨环境温度与胰岛素使用者低血糖相关急诊就诊或住院治疗之间的关系。研究设计和方法 我们确定了 2016 年 6 月至 2019 年 9 月期间美国(通过符合医疗保险 A/B/D 部分的受益人)和台湾(通过国民健康保险数据库)年龄≥65 岁的使用胰岛素的成人中发生严重低血糖的病例。然后,我们采用条件逻辑回归和时间分层病例交叉设计,根据热指数(HI)百分位数类别估算了低血糖的几率。结果 在美国 200 万胰岛素使用者中(32461 例低血糖病例受试者),与 25-74 百分位数相比,HI >99、95-98、85-94 和 75-84 百分位数的低血糖几率比为 1.38(95% CI,1.28-1.48)、1.14(1.08-1.20)、1.12(1.08-1.17)和 1.09(1.04-1.13)。台湾样本中的胰岛素使用者(∼283,000 名胰岛素使用者,10,162 名低血糖病例受试者)的整体关联模式相似。结论 在两个国家的老年胰岛素使用者样本中,较高的环境温度与低血糖风险增加有关。
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Ambient Heat and Risk of Serious Hypoglycemia in Older Adults With Diabetes Using Insulin in the U.S. and Taiwan: A Cross-National Case-Crossover Study
OBJECTIVE To measure the association between ambient heat and hypoglycemia-related emergency department visit or hospitalization in insulin users. RESEARCH DESIGN AND METHODS We identified cases of serious hypoglycemia among adults using insulin aged ≥65 in the U.S. (via Medicare Part A/B/D-eligible beneficiaries) and Taiwan (via National Health Insurance Database) from June to September, 2016–2019. We then estimated odds of hypoglycemia by heat index (HI) percentile categories using conditional logistic regression with a time-stratified case-crossover design. RESULTS Among ∼2 million insulin users in the U.S. (32,461 hypoglycemia case subjects), odds ratios of hypoglycemia for HI >99th, 95–98th, 85–94th, and 75–84th percentiles compared with the 25–74th percentile were 1.38 (95% CI, 1.28–1.48), 1.14 (1.08–1.20), 1.12 (1.08–1.17), and 1.09 (1.04–1.13) respectively. Overall patterns of associations were similar for insulin users in the Taiwan sample (∼283,000 insulin users, 10,162 hypoglycemia case subjects). CONCLUSIONS In two national samples of older insulin users, higher ambient temperature was associated with increased hypoglycemia risk.
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来源期刊
Diabetes Care
Diabetes Care 医学-内分泌学与代谢
CiteScore
27.80
自引率
4.90%
发文量
449
审稿时长
1 months
期刊介绍: The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.
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