Abstract
Objective To explore the clinical outcomes and establish a predictive
model of hypoglycemia during colonoscopy preparation for diabetic patients.
Methods Three-hundred ninety-four patients with diabetes who received
colonoscopy were retrospectively enrolled in this study and assigned to
hypoglycemia or non-hypoglycemia groups. Information about clinical
characteristics and outcomes during colonoscopy preparation was collected and
compared between the two groups. Logistic regression analysis was applied to
identify the risk factors of hypoglycemia. These risk factors were used to
construct a hypoglycemia predictive model verified by the receiver operating
characteristic (ROC) curve and Hosmer-Lemeshow goodness fit test.
Results Among 394 participants, 66 (16.8%) underwent a total of 88
hypoglycemia attacks during the bowel preparation. Grade 1 hypoglycemia
(≤3.9 mmol/L) comprised 90.9% (80/88) of
all hypoglycemia attacks and grade 2 hypoglycemia accounted for 9.1%
(8/88), signifying that grade 1 hypoglycemia is the most common type. No
severe hypoglycemia was identified. The incidence of nocturnal hypoglycemia was
15.9%. Logistic regression analyses revealed that the main risk factors
of hypoglycemia during colonoscopy preparation were postprandial C-peptide,
serum triglyceride, gender, type of diabetes mellitus, and insulin injection
frequencies. The area under the ROC curve of the hypoglycemia prediction model
was 0.777 (95% CI: 0.720–0.833).
Conclusion Diabetic patients are prone to develop mild to moderate
hypoglycemia during colonoscopy preparation. This study proposes a predictive
model that could provide a reference for identifying patients with a high risk
of hypoglycemia during colonoscopy preparation.
Key words
diabetes - colonoscopy - hypoglycemia - predictive model
