1.The incidence of in-hospital hypoglycemia and its associated risk factors among adult Filipino patients with Diabetes Mellitus in Chong Hua Hospital
Ma. Vircel Duyongco-Tiu ; Imelda Lagula-Bilocura
Philippine Journal of Internal Medicine 2017;55(4):1-8
Introduction:
Hypoglycemia is a burdensome complication
in the management of diabetes mellitus (DM), and has
been noted to be increasing. This study evaluated the
occurrence of hypoglycemia and identified its risk factors
among diabetic Filipino patients.
Methods:
Census of Filipino non-pregnant adults with type 2
DM of Chong Hua Hospital, admitted and discharged from
January 2015 to June 2015 was taken. This study determined
the incidence rate of hypoglycemia (capillary blood glucose
<70 mg/dL), its severity, patients’ dietary status, medication,
and the common hospital areas where hypoglycemia
occurred. The clinical profiles of these patients were
analyzed and associated risk factors of hypoglycemia were
identified. Also, the incidence of congestive heart failure,
myocardial infarction, cerebrovascular disease, and allcause mortality among patients with hypoglycemia were
determined.
Results:
Among 1,676 subjects, 8.9% had hypoglycemia
predominantly non-severe type (blood glucose 51-69 mg/dL). The identified risk factors for the development
of hypoglycemia were the following, age >65 years old
(52.7% vs 36.2%, p<0.001), diabetes duration of 8.56 years
(± 10.34 years), the presence of cardiovascular disease
(62.7% vs 48.6%, p<0.001), congestive heart failure (8.7% vs
4.4%, p=0.009) and stage III, IV, V kidney disease (32.7% vs
25.1%, p=0.043, 12% vs 5.5%, p=0.002, 12% vs 4.1%, p<0.001,
respectively), and the use of insulin whether combined
with oral therapy (25.3% vs 16.5%, p<0.006) or used alone
(34.7% vs 12.1%, p<0.001). Hypoglycemia occurred more
frequently in the non-ICU ward (82.7%). Only one patient
developed non-fatal myocardial infarction, one had nonfatal cerebrovascular disease and one had congestive heart
failure. All-cause mortality rate was 4.7%
Conclusion
The notable incidence of in-hospital
hypoglycemia of 8.9% among diabetic patients should
be addressed to decrease the associated morbidity and
mortality.
Hypoglycemia
;
Diabetes Mellitus
2.Correlation between admitting blood glucose levels and H=hospital outcome in patients who underwent percutaneous coronary intervention
Alta Gracia B. Damalerio ; Imelda Lagula-Bilocura ; Ma. Vircel Duyongco-Tiu
Philippine Journal of Internal Medicine 2021;59(4):301-306
Objectives:
This study aimed to determine the correlation between admitting hyperglycemia and hospital outcome, on
the length of hospital stay and mortality on patients who underwent PCI.
Methodology:
A single center, retrospective observational study involving patients who underwent percutaneous
coronary intervention (PCI). They were divided in four (4) groups according to presence of admission hyperglycemia (capillary blood glucose >140mg/dl) and presence of diabetes: Group 1 (patients with diabetes with admission hyperglycemia), Group 2 (patients without diabetes with admission hyperglycemia), Group 3 (patients with diabetes without admission hyperglycemia), and Group 4 (patients without diabetes without admission hyperglycemia). Length of hospital stay and mortality outcome were compared between four groups and in-hospital mortality related risk factors were analyzed by binary logistic regression analysis.
Results:
133 patients were included in the analysis, of which 50% have admission hyperglycemia. The length of hospital stay was significantly longer in patients with admission hyperglycemia (12 vs 9 vs 7 vs 7 days, p= 0.006). The mortality rate between 4 groups were non-significant (14% vs 10% vs 9% vs 11%, p=0.272). Multiple logistic regression analysis showed the following were associated with increased mortality in patients who underwent PCI: age (odds ratio [OR] 1.1265, 95%CI 1.0497 – 1.2090, p=0.001), capillary blood glucose on admission (OR 1.0077, 95% CI 1.0015 – 1.0140, p= 0.015), presence of ST elevation on ECG (OR 16.5671, 95% CI 3.4161 – 80.344, p=<0.001).
Conclusion
An elevated admission capillary blood glucose, regardless of presence or absence of diabetes, was associated with longer length of hospital stay; however, it was not predictive of in-hospital mortality. Interestingly, patients with admitting hyperglycemia had earlier mortality.
Diabetes Mellitus