Predicting hypoglycemia risk after gastrointestinal surgery in type 2 diabetes mellitus: a retrospective cohort study

作者：Huilan Yao, Shijin Yuan, Hongying Pan, Sisi Hong, Chen Huang, Linfang Zhao, Hongdi Yuan, Lei Mei, Yinghong Zheng, Xiaolong Liu, Wei Lü · 发表于：Frontiers in Endocrinology · 年份：2025 · DOI：10.3389/fendo.2025.1590780 · 被引用次数：2 · 研究领域：Hyperglycemia and glycemic control in critically ill and hospitalized patients、Bariatric Surgery and Outcomes、Metabolism, Diabetes, and Cancer

Objective: To identify factors influencing hypoglycemia in patients with type 2 diabetes mellitus (T2DM) following gastrointestinal tumor surgery and construct a predictive model for assessing hypoglycemia risk. Methods: We retrospectively collected data on 1280 patients with T2DM who underwent gastrointestinal tumor surgery and divided them into two groups-one for model building (n = 982) and another for validation (n = 298). We used multivariate logistic regression to develop a predictive model for hypoglycemia following gastrointestinal tumor surgery. The model's predictive performance was evaluated using the area under the receiver operating characteristic (ROC) curve, and its generalization ability was evaluated using the bootstrap test and the five-fold cross-validation test. Results: We identified hypoglycemia following gastrointestinal tumor surgery in 124 of 982 (12.6%) T2DM patients in the developmental cohort. Finally, five predictors, including duration of diabetes, operation duration, preoperative fasting time, preoperative hypoglycemic regimen (subcutaneous insulin injection), and glucose fluctuation on the day of surgery, were integrated into the predictive model. The performance of the hypoglycemia risk prediction model for patients with T2DM undergoing gastrointestinal tumor surgery was comprehensively evaluated. The model demonstrated an area under the ROC curve (AUC) of 0.837 (95% CI: 0.792-0.882), indicating a strong discriminative ability. Internal valida...