国际老年医学杂志2026，Vol.47Issue(2)：171-176,6.DOI:10.3969/j.issn.1674-7593.2026.02.008
格列美脲治疗老年糖尿病时发生低血糖风险的预测模型
Prediction model for hypoglycemia risk in the treatment of elderly diabetes with glimepiride
摘要
Abstract
Objective To construct a risk prediction model for hypoglycemia in elderly patients with type 2 diabetes treated with glimepiride,providing a basis for individualized clinical medication.Methods The clinical data of 241 elderly patients(aged≥60 years)with type 2 diabetes who were regularly treated with oral glimepiride(monotherapy or in combination with other hypoglycemic agents)were retrospectively collected from the Department of Geriatrics,Nanjing First Hospital,from October 2022 to October 2024.According to whether patients experienced symptomatic or asymptomatic hypoglycemic events during treatment with glimepiride,they were divided into a hypoglycemic group of 60 cases(24.90%)and a non hypoglycemic group of 181 cases(75.10%).The independ-ent influencing factors of hypoglycemia in elderly diabetes patients treated with glimepiride were screened through single factor analysis and multi factor logistic regression analysis,and the predictive model was constructed and its efficacy was evaluated.Results Univa-riate analysis showed that there were statistically significant differences between the hypoglycemia group and the non hypoglycemia group in terms of age,duration of diabetes,body mass index,estimated glomerular filtration rate(eGFR),serum albumin,daily dose of glimepiride,previous history of hypoglycemia,combined use of insulin,and combined use of β-blockers(P<0.05).Multivariate logistic regression analysis revealed that advanced age,lower eGFR,higher daily dose of glimepiride,a previous history of hypoglyce-mia,and combined use of insulin were independent risk factors for glimepiride-induced hypoglycemia in elderly patients with type 2 di-abetes(P<0.05).The area under the curve of the ROC curve prediction model is 0.882(95%CI:0.812-0.918,P<0.001).The probability value of 0.251 corresponding to the maximum point of the Jordan index on the ROC curve(0.579)is selected as the opti-mal critical point.At this point,the sensitivity of the model is 78.33%,the specificity is 79.56%,the positive predictive value is 55.95%,and the negative predictive value is 91.72%.Conclusion The prediction model based on advanced age,renal function,drug dose,history of hypoglycemia and insulin combination has good clinical value in predicting the risk of hypoglycemia in elderly pa-tients with diabetes during glimepiride administration.关键词
格列美脲/2 型糖尿病/低血糖/风险预测Key words
Glimepiride/Type 2 diabetes/Hypoglycemia/Risk prediction引用本文复制引用
陈文洁,李林,季梅丽,戴露..格列美脲治疗老年糖尿病时发生低血糖风险的预测模型[J].国际老年医学杂志,2026,47(2):171-176,6.基金项目
江苏省干部保健科研课题(BJ24038) （BJ24038）
