Abstract: Objective To explore the relationship between estimated glomerular filtration rate(eGFR) and the risk of hypoglycemia in the elderly patients with diabetes mellitus(DM). Methods The clinical data of 532 elderly patients with DM who were hospitalized in West China Hospital of Sichuan University from July 2020 to April 2021 were collected. According to the level of eGFR, the patients were divided into 5 groups: eGFR≥90 mL/(min·1.73m²)(group A, n=80), 60 mL/(min·1.73m²)≤eGFR＜90 mL/(min·1.73m²)(group B, n=201), 30 mL/(min·1.73m²)≤eGFR＜60 mL/(min·1.73m²)(group C, n=84), 15 mL/(min·1.73m²)≤eGFR＜30 mL/(min·1.73m²)(group D, n=81), and eGFR<15 (mL/ min·1.73m²)(group E, n=86).The differences of baseline data among 5 groups were analyzed. Logistic regression analysis was used to analyze the risk factors of hypoglycemia. Results The overall incidence rate of hypoglycemia was 13.9%(74/532). The incidence rate of hypoglycemia increased from 17.9%(15/84) to 20.9%(18/86) with the decrease of eGFR, and the difference was statistically significant(P<0.05). After adjusting for age, gender, duration of diabetes, glycosylated hemoglobin (HbA1c), body mass index(BMI), insulin usage and other confounding factors, eGFR was still an independent risk factor for hypoglycemia. The risk of hypoglycemia in group C was 3.54 times higher than that in group A(95% CI: 1.06-11.84,P<0.05);and 3.92 times(95%CI: 1.14-13.44, P<0.05) in group D, 4.01 times(95%CI: 1.23-13.07, P<0.05) in group E, respectively. Conclusions eGFR is closely related to the risk of hypoglycemia in the elderly patients with DM. eGFR is expected to be used for personalized assessment and prediction of the risk of hypoglycemia in the elderly patients with DM.

Key words: diabetes, aged, hypoglycemia, estimated glomerular filtration rate