Severe Hypoglycemia in Type 2 Diabetes: A Hospital-based Retrospective Study

Abstract

Background and Purpose: For patients with diabetes, severe hypoglycemia has a significant economic impact and adverse effect on quality of life. The aim of this study was to assess the incidence of and risk factors for severe hypoglycemia among patients with type 2 diabetes. Methods: We evaluated a cohort of 1195 patients with type 2 diabetes followed in the outpatient clinic of Mackay Memory Hospital, Taitung, Taiwan from January 1 through December 31, 2004. Medical records were retrospectively reviewed for demographics, medical history, duration of diabetes, results of laboratory tests, and current diabetes therapy. We used univariate and multivariate logistic regression to determine risk factors for severe hypoglycemia. Results: The overall incidence of severe hypoglycemia was 7.4%. Patients on insulin therapy had higher incidence than patients on oral hypoglycemic agents alone (17.8% vs. 6.3% P＜0.001). Multiple logistic regression showed that the risk of severe hypoglycemia increased with older age (P＜0.001), lower educational level (P=0.02), HbA(subscript 1c) level lower than 7.0% (P＜0.001), current insulin therapy (P＜0.001), and impaired renal function (P=0.01) Conclusion: Older age, lower educational level, HbA(subscript 1c)≦7, current insulin therapy and impaired renal function are risk factors of severe hypoglycemia in type 2 diabetes.