Philippine Journal of Internal Medicine 2017;55(4):1-8

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 1 ; Imelda Lagula-Bilocura 2

Affiliations

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Keywords

Diabetes

Country

Philippines

Language

English

Abstract

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.