Precipitating Factors of Hypoglycemia in Diabetic Patients Undergoing Treatment in Taksin Hospital

Abstract

Background: Hypoglycemia is the most common complication and the most important obstacle to overcome to achieve good glycemic control in diabetic patients. It causes serious consequences, leading to increased morbidity and mortality. Objective: To identify the precipitating factors of hypoglycemia in diabetic patients undergoing treatment in Taksin hospital. Materials and Methods: A case-control study was conducted in 110 diabetic patients admitted due to hypoglycemia and 110 diabetic patients admitted for other reasons at Taksin Hospital, between October 2019 and September 2020. The sociodemographic information, clinical data, and precipitating causes of hypoglycemia were obtained from medical records. Logistic regression analysis was performed to identify the risk factor and reported as odds ratio (OR) with 95% confidence intervals (CI). Results: The multiple logistic regression analysis showed that the precipitating factors related to hypoglycemia among diabetic patients with a significant p-value (p<0.05) were poor self-care knowledge of hypoglycemia prevention (adjusted OR 14.37, 95% CI 5.75 to 35.89), insulin treatment in diabetic patients (adjusted OR 13.78, 95% CI 5.43 to 34.99), and intensive glycemic control HbA1c of less than 6% (adjusted OR 3.64, 95% CI 1.70 to 7.79). Furthermore, the result from the present study showed that individual factors were statistically significant and related to hypoglycemia. The factors included the age more than 60 years, low education level, functionally dependent patients, diabetes duration more than 10 years, hypertension, dyslipidemia, diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, and cognitive impairment. Conclusion: Poor self-care knowledge of hypoglycemia prevention, insulin treatment in diabetic patients, and intensive glycemic control were strong predictors of hypoglycemia in diabetic patients undergoing treatment in Taksin Hospital. Therefore, diabetes self-management education and tailoring diabetic therapy should be provided in diabetic patients to improve treatment and prevention of hospitalization due to hypoglycemia in diabetes. Keywords: Diabetes Mellitus; Hypoglycemia; Precipitating factor; Hospitalization