https://scholars.lib.ntu.edu.tw/handle/123456789/522931
標題: | Hypoglycemic episodes are associated with an increased risk of incident frailty among new onset diabetic patients | 作者: | CHIA-TER CHAO Wang J. JENQ-WEN HUANG DING-CHENG CHAN KUO-LIONG CHIEN on behalf of COhort of GEriatric Nephrology in NTUH (COGENT) study group |
公開日期: | 2020 | 出版社: | Elsevier Inc. | 卷: | 34 | 期: | 2 | 起(迄)頁: | 107492 | 來源出版物: | Journal of Diabetes and its Complications | 摘要: | Aims: Patients with diabetes mellitus (DM) are at risk for developing frailty due to the complex interplay between different cardiometabolic factors. We examined whether hypoglycemia could independently increase frailty risk besides these factors. Methods: From the Longitudinal Cohort of Diabetic Patients, 210,254 patients with new onset DM between 2004 and 2011 were identified, among whom 2119 non-frail patients had at least 1 hypoglycemic episode within 3 years of DM diagnosis. They were propensity score-matched to 8432 non-frail ones without hypoglycemia throughout the study period. Both groups were followed up longitudinally for incident physical frailty according to a modified FRAIL scale (Fatigue, Resistance, Ambulation, Illness, and Loss of weight). We analyzed the risk of frailty (primary) and mortality (secondary outcome) introduced by hypoglycemia, adjusted for known risk factors of frailty. Results: The mean age of patients (46.2% male) was 65.9 ± 14 years; diabetic patients with hypoglycemia had significantly higher comorbidity burden than those without. After 2.68 years, 172 (1.6%) patients with hypoglycemia developed incident frailty, representing a 60% higher risk (hazard ratio [HR] 1.599, 95% confidence interval [CI] 1.14–2.42). After adjusting for other risk factors, those with hypoglycemia had a significantly higher risk of frailty than those without (HR 1.443, 95% CI 1.01–2.05). Additionally, the mortality of those with hypoglycemia was 2-fold higher than those without, and the risk persisted despite confounder adjustment (HR 1.462, 95% CI 1.3–1.65). Conclusion: In this population-based cohort, hypoglycemic episodes among diabetic patients increased the risk of incident frailty and mortality. ? 2019 Elsevier Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85076521316&doi=10.1016%2fj.jdiacomp.2019.107492&partnerID=40&md5=d7c6ee250a74b76d18c479b20ff73bc7 https://scholars.lib.ntu.edu.tw/handle/123456789/522931 |
ISSN: | 1056-8727 | DOI: | 10.1016/j.jdiacomp.2019.107492 | SDG/關鍵字: | aged; Article; cohort analysis; controlled study; diabetes mellitus; diabetic patient; female; frailty; human; hypoglycemia; longitudinal study; major clinical study; male; mortality; priority journal; rating scale; risk assessment; risk factor; comorbidity; diabetic complication; frailty; hypoglycemia; incidence; middle aged; Aged; Comorbidity; Diabetes Complications; Female; Frailty; Humans; Hypoglycemia; Incidence; Longitudinal Studies; Male; Middle Aged; Risk Factors |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。