Epidemiology of hypoglycemia among ambulatory Type 2 diabetic patients in a primary care clinic of a tertiary hospital in Southeastern Nigeria

Abstract

Aim: The study was aimed at describing the epidemiology of hypoglycemia among ambulatory type 2 diabetic patients in a primary care clinic in Eastern Nigeria. Materials and Methods: A cross-sectional descriptive study was carried out on 145 type 2 diabetic patients in a primary care clinic in Nigeria. Data were collected using pretested, structured, and interviewer-administered questionnaire containing information on relevant epidemiological variables. Experience of hypoglycemia was defined as self-reported symptoms of hypoglycemia in the previous 1 year. Results: The age of type 2 diabetic patients ranged from 32 to 78 years with mean age of 44 ± 10.2 years. There were 59 (40.7%) males and 86 (59.3%) females. The prevalence of hypoglycemia was 35.2%. Hypoglycemia occurred predominantly among the elderly (72.5%), male gender (54.9%), outside home environment (72.5%), during the daytime (82.4%), duration of diabetes ≤1 year (58.8%), and patients on insulin secretagogues alone (46.2%). The most common symptom was dizziness (76.5%). Experience of hypoglycemia was significantly associated with elderly age (P = 0.025), duration of diabetes ≤1 year (P = 0.021), and use of insulin secretagogues alone (P = 0.043). The most significant predictor of hypoglycemic events was use of insulin and insulin secretagogues (odds ratio = 3.15 [1.74–5.66]; P = 0.002). Type 2 diabetic patients on insulin and insulin secretagogues were three times more likely to experience hypoglycemic events compared to their counterparts who were on insulin sensitizers. Conclusion: The study has shown variable epidemiology of hypoglycemia. The incident occurred predominantly among the elderly, male gender, during daytime, outside home environment, duration of diabetes ≤1 year, and patients on insulin and insulin secretagogues. Interventional measures for hypoglycemia should consider relevant epidemiological factors that predispose to hypoglycemia.