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
Keywords
Diabetes
Country
Philippines
Language
English
MeSH
ACTIONS
ACTIONS
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.
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