Severe hypoglycemia in diabetics requiring hospitalization and short-term mortality

Abstract

We planned a prospective study to observe short-term mortality in diabetic patients with severe hypoglycemia requiring hospitalization. Total 50 patients were enrolled in the study. Diabetic patients presenting to hospital with plasma glucose <70 mg/dl requiring hospitalization for correction were enrolled in study. Patients with underlying malignancy, acute cerebro-vascular event, symptomatic congestive heart failure, and creatinine clearance <10 ml/min/1.73 m2 were excluded. All subjects were followed for 3 months from date of admission. Majority of patients were type 2 diabetics (41, 82%) and remaining were type 1 diabetics. Mean age of type 1 diabetic was 31.77 ± 8.9 years and for type 2 diabetic was 65.97 ± 10.5 years. Mean plasma glucose at presentation was 36.62 ± 11.57 mg/dl. Fourteen (28%) patients had previous admission with hypoglycemia. Thirty patients did not have knowledge about hypoglycemia management at home. Seventeen (34%) were on single drug (insulin/SU), 19 (38%) were on two drugs, and 14 (28%) were on three or more drugs. Mean creatinine clearance was 55.83 ± 26.5 ml/min/1.73 m2. Mean HbA1C was 8.58 ± 1.94%. Total in-hospital mortality was two (4%), and two more deaths were observed during 3-month follow-up. All four deaths occurred in type 2 diabetics who were illiterate and had no previous history of severe hypoglycemia. Total in-hospital mortality was 2/50 (4%) and 90-day all-cause mortality was 4/50 (8%). All patients who died were type 2 diabetic; hence, all-cause mortality was 4/41 (9.7%) in type 2 diabetes. Our study suggests that severe hypoglycemia, particularly in type 2 diabetes, is associated with very significant all-cause mortality in short term.