Clinical characteristics and hospitalisation outcomes of hypoglycaemia in hospitalised patients with type 2 diabetes mellitus

Abstract

Background/Aim: Strict glycaemic control delays the onset as well the progression of diabetes related microvascular complications. The major roadblock in achieving the target glycated haemoglobin (HbA 1 c) and blood glucose levels is hypoglycaemia. The aim of this study was to assess the clinical characteristics and outcomes of hypoglycaemia in the type 2 diabetes mellitus (T2DM) hospitalised patients. Methods: This was an observational study done for nine months in T2DM patients who had documented hypoglycaemia (blood glucose < 70 mg/ dL) during the hospital stay. T2DM patients with hypoglycaemia on admission , hypoglycaemia due to anti-diabetic drug overdose, intensive care unit (ICU) patients with hypoglycaemia were excluded from the study. Eligible patients were categorised into two groups as symptomatic and as-ymptomatic hypoglycaemia. Clinical features, risk factors, hospitalisation outcome were compared between the symptomatic and asymptomatic hypoglycaemia group. Results: Two hundred patients were enrolled in this study (n = 89, symptomatic group and n = 111, asymptomatic hypoglycaemia). Hypoglycaemic episode in past was significantly associated with symptomatic hypoglycaemic events during hospitalisation [34 (38.2 %) vs 27 (24.3 %)], p = 0.01. Admission blood glucose levels (mg/dL), HbA 1 c (%) were significantly higher in symptomatic hypoglycaemia group [(225.93 vs 178.72, p = 0.008), (8.55 ± 2.49 vs 7.72 ± 1.82, p = 0.007)], respectively. The blood glucose level during the hypoglycaemia episode was significantly higher in patients with asymptomatic hypoglycaemia group (56.38 ± 9.51 vs 44.22 ± 11.21 mg/dL, p < 0.001). Patients with HbA 1 c ≤ 6 % were significantly higher in asymptomatic hypoglycaemia (n = 12, 10.8 % vs n = 2, 2.24 %, p = 0.02). Majority recovered fully without complications and got discharged (n = 155, 77.5 %). Conclusion: In presented study, symptomatic hypoglycaemic patients had significantly higher admission blood glucose levels and HbA 1 c %. Patients with HbA 1 c < 6 % were significantly higher in asymptomatic group. Past history of hypoglycaemia was significantly associated with symptomatic hypoglycaemia during hospitalisation.