Yonsei Med J.  2010 May;51(3):367-374. 10.3349/ymj.2010.51.3.367.

Risk Factors for Recurrent Hypoglycemia in Hospitalized Diabetic Patients Admitted for Severe Hypoglycemia

• Lin YY
• Hsu CW
• Sheu WH
• Chu SJ
• Wu CP
• Tsai SH

• KMID: 1074988
• DOI: http://doi.org/10.3349/ymj.2010.51.3.367

Abstract

PURPOSE
Severe hypoglycemia can result in neural damage, impaired cognitive function, coma, seizures, or death. The decision to admit diabetic patients after initial treatment in the emergency department remains unclear. Our purpose is to identify risk factors for developing recurrent hypoglycemia in diabetic patients admitted for severe hypoglycemia.
MATERIALS AND METHODS
We reviewed the records of 233 subjects (92 males, 141 females; mean age, 74.1 +/- 9.8 years) with type 2 diabetes treated at a tertiary care teaching hospital and hospitalized for severe hypoglycemia.
RESULTS
Seventy-four (31.8%) patients were categorized with recurrent hypoglycemia and 159 (68.2%) with non-recurrent. Multivariate logistic regression analysis revealed that patients with loss of a recent meal, coronary artery disease, infection, and poor renal function (lower estimated glomerular filtration rate) were at risk for recurrent hypoglycemia. The use of calcium-channel blockers appeared to be a protective factor for the development of recurrent hypoglycemia.
CONCLUSION
There may be a subset of patients with severe hypoglycemia and certain risk factors for recurrent hypoglycemia that should be admitted.

Keyword

Hypoglycemia; type 2 diabetes; mellitus; chronic kidney disease; coronary artery disease; calcium channel blockers; diabetic complications

MeSH Terms

Aged
Aged, 80 and over
Calcium Channel Blockers/adverse effects/therapeutic use
Coronary Artery Disease/complications
Diabetes Mellitus, Type 2/complications
Female
Glomerular Filtration Rate
Hospitalization
Humans
Hypoglycemia/*etiology/*prevention & control
Kidney Diseases/complications
Logistic Models
Male
Multivariate Analysis
Recurrence
Retrospective Studies
Risk Factors

Figure

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  Fig. 1 Patient enrollment.

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