title: Increasing trend in the number of severe hypoglycemia patients in Korea.
abstract: BACKGROUND
  To investigate whether the number of subjects with severe hypoglycemia who are brought to a hospital emergency department is increasing and to identify whether there have been changes in the demographic and clinical characteristics of those subjects.
  
  
  METHODS
  We analyzed data from the Emergency Departments of two general hospitals in Seoul, Korea. We included data from all adult subjects with type 2 diabetes who presented to an emergency department with severe hypoglycemia between January 1, 2004 and December 30, 2009.
  
  
  RESULTS
  A total of 740 cases of severe hypoglycemia were identified. The mean subject age was 69±12 years, mean duration of diabetes was 13.8±9.3 years, and 53.2% of subjects were receiving insulin therapy. We observed a sharp rise in the number of cases between 2006 and 2007. Stages 3-5 chronic kidney disease was diagnosed in 31.5% of subjects, and low C-peptide levels (<0.6 ng/mL) were found in 25.5%. The mean subject age, duration of diabetes, HbA1c level, and renal and insulin secretory function values did not change significantly during the study period. The proportion of glimepiride use increased, while use of gliclazide decreased among sulfonylurea users. Use of insulin analogues increased, while use of NPH/RI decreased among insulin users.
  
  
  CONCLUSIONS
  We identified a sharp increase in the number of subjects with severe hypoglycemia presenting to an emergency room since 2006. The clinical characteristics of these subjects did not change markedly during the study period. Nationwide studies are warranted to further clarify this epidemic of severe hypoglycemia.
authors: Department of Internal Medicine, Eulji University Hospital, Eulji University College of Medicine, Seoul, Korea.
authors: Jin Taek
authors: JT
authors: Kim
authors: Tae Jung
authors: TJ
authors: Oh
authors: Ye An
authors: YA
authors: Lee
authors: Jun Ho
authors: JH
authors: Bae
authors: Hyo Jeong
authors: HJ
authors: Kim
authors: Hye Seung
authors: HS
authors: Jung
authors: Young Min
authors: YM
authors: Cho
authors: Kyong Soo
authors: KS
authors: Park
authors: Soo
authors: S
authors: Lim
authors: Hak Chul
authors: HC
authors: Jang
authors: Hong Kyu
authors: HK
authors: Lee