J Korean Diabetes.  2016 Sep;17(3):202-211. 10.4093/jkd.2016.17.3.202.

Characteristics of Hypoglycemia Pateints Visiting the Emergency Department of a University Hospital

• Choi SH
• Youn DK
• Choi MG
• Ryu OH

• KMID: 2354286
• DOI: http://doi.org/10.4093/jkd.2016.17.3.202

Abstract

BACKGROUND
Hypoglycemia is an important obstacle in the treatment of diabetes. When diabetic patients experience hypoglycemia, thorough glycemic control is more difficult. We evaluated the factors associated with risk of hypoglycemia and identified whether the demographic and clinical characteristics or the medication pattern changed during the study period.
METHODS
This study was conducted retrospectively with 7 years of data from one university hospital emergency department. We evaluated the medical records of 396 diabetic patients who visited the emergency room with hypoglycemia between January 2008 and December 2014. Hypoglycemia was defined as a serum glucose level less than 70 mg/dL or an event requiring the assistance of another person to actively corrective action.
RESULTS
The mean age, duration of diabetes, and hemoglobin A1c (HbA1c) of the study subjects were 71 ± 12.2 years, 12.7 ± 8.8 years, and 6.7 ± 1.39%, respectively. Among the subjects, 55% had a HbA1c level lower than 6.5%. Two-thirds of the study subjects received sulfonylurea, and one-third were treated with insulin. We observed a decreasing trend in the number of hypoglycemia cases during the study period. This trend might be partly explained by the decrease in sulfonylurea use and increase in dipeptidyl peptidase 4 inhibitor prescription during the study period.
CONCLUSION
The clinical characteristics of subjects with hypoglycemia were old age, long duration of diabetes, relatively low HbA1c, and comorbidities. We found that hypoglycemia events in diabetic patients decreased in number in conjunction with the changing pattern of use of hypoglycemic agents.

Keyword

Diabetes mellitus; Hypoglycemia; Hypoglycemic agents

MeSH Terms

Blood Glucose
Comorbidity
Diabetes Mellitus
Dipeptidyl Peptidase 4
Emergencies*
Emergency Service, Hospital*
Humans
Hypoglycemia*
Hypoglycemic Agents
Insulin
Medical Records
Prescriptions
Retrospective Studies
Dipeptidyl Peptidase 4
Hypoglycemic Agents
Insulin

Figure

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  Fig. 1. Number of subjects according to year of presentation with hypoglycemia.

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  Fig. 2. The number of outpatient prescriptions of hypoglycemic agents at Chuncheon Sacred Heart Hospital by year. DPP-4 inhibitor, dipeptidyl peptidase 4 inhibitor.

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  Fig. 3. The number of outpatient insulin prescriptions at Chuncheon Sacred Heart Hospital by year. NPH, Neutral Protamine Hagedorn Insulin.

Reference

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