Characteristics and mortality of type 2 diabetic patients hospitalized for severe iatrogenic hypoglycemia.
OBJECTIVE
Severe hypoglycemia can be dramatic in diabetic patients, but its long-term outcome is unknown. We aimed to describe clinical characteristics of type 2 diabetic patients hospitalized for iatrogenic hypoglycemia, and find predictors of long-term mortality, with a special regard to anti-hyperglycemic regimens.


METHODS
We retrospectively analyzed 126 episodes of severe hypoglycemia in type 2 diabetic patients. We collected data on the event (coma, pre-hospital fall, glucose level, duration of hypoglycemia), concomitant risk factors, diabetic complications and chronic comorbidities. We divided patients according to the use of insulin or oral agents (OHAs). In-hospital outcomes were acute coronary syndrome (ACS) and duration of hospitalization. We finally assessed long-term mortality.


RESULTS
Hypoglycemia due to OHA was associated with higher prevalence of coma and longer duration than hypoglycemia due to insulin. OHA use was also associated with a longer hospital stay, but no increase in the incidence of ACS. Overall mortality after a 2-year median follow-up was 42.1%. Despite the apparent worse presentation of hypoglycemic episodes associated with OHA use, this did not lead to an increased long-term mortality.


CONCLUSIONS
Severe iatrogenic hypoglycemia in OHA-treated patients has a worse presentation, but is not associated with a higher long-term mortality than in insulin-treated patients.
Fadini
Gian Paolo
GP
Department of Clinical and Experimental Medicine, Metabolic Division, University of Padova, Medical School, Padova, Italy. gianpaolofadini@hotmail.com
Rigato
Mauro
M
Tiengo
Antonio
A
Avogaro
Angelo
A
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000401:mortality; D005260:Female; D005919:Glomerular Filtration Rate; D006760:Hospitalization; D006801:Humans; D007003:Hypoglycemia / Q000097:blood* / Q000401:mortality*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects; D007049:Iatrogenic Disease; D007297:Inpatients; D007328:Insulin / Q000009:adverse effects; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors
D007004:Hypoglycemic Agents; D007328:Insulin; D003404:Creatinine