INTRODUCTION

Type 2 diabetes has become a worldwide epidemic and is associated with multiple complications that can be prevented by optimizing glycemic control. However, hypoglycemia is the main limiting factor in the glycemic management of type 2 diabetes.

AIMS OF THE STUDY

To identify risk factors for hypoglycemia  in diabetic patients admitted for hypoglycemia.

STUDY DESIGN AND METHODS

Case control study. 

From 8/2011 to 8/2012, 144 hypoglycemia patients admitted to the hospital were included in this study. Control group included 144 outpatients and 144 inpatients did not have hypoglycemia on that same day and were matched by age and sex. Data collected for demographics, medical history, eating habits, nutritional status, comorbidity, duration of diabetes, results of laboratory tests. Multivariate logistic regression were used to determine risk factors for severe hypoglycemia.

RESULTS AND CONCLUSIONS

Mean age (SD) of diabetic patients admitted for hypoglycemia was 74.3 (11) years. Hypoglycemic patients had higher prevalence  of previous stroke compared with outpatient and inpatient control groups (33.3%  vs 6.9%, 15.3%, respectively). 57.5%, 12.2 % and 40.3% hypoglycemic patients had HbA1c <6.5%; 6.5-6.9 and >7% compared with 9.1%,10.5% and 80.4% and 11.4%, 4.3% and 84.3% outpatient and inpatient  control group, respectively. 39.8% hypoglycemic patients had recent dosage change before admission compared with only 14.9% and 7.8%  in control groups. Interestingly, only 9.8% patients admitted by hypoglycemia had diabetes management by diabetic specialists compared with 89.6% and 31.3% in control groups. Multivariate analysis identifies previous stroke, decreased food intake/skipped meal, recent dosage change and tight glycemic control (HbA1c<7%) as risk factors of hypoglycemia.