Blood electrolyte disturbances during severe hypoglycemia in Korean patients with type 2 diabetes.
OBJECTIVE
To investigate abnormalities in blood electrolyte levels during severe hypoglycemia in Korean patients with type 2 diabetes mellitus (T2DM) in a clinical setting.


METHODS
Blood electrolyte levels in adult T2DM patients during severe hypoglycemia were collected from January 1, 2008 to December 31, 2012. Patients who maintained normal serum creatinine and blood urea nitrogen levels were utilized in the study. Severe hypoglycemia was defined as a condition requiring medical assistance, such as administering carbohydrates when serum glucose levels less than 70 mg/dL were observed, in conjunction with other symptoms of hypoglycemia.


RESULTS
A total of 1,068 patients who visited the emergency room with severe hypoglycemia were screened, of which 219 patients were included in this study. The incidence of abnormal levels for any electrolyte was 47%. Hypokalemia (< 3.5 mmol/L) was the most common type of electrolyte disturbance observed at 21.9%. A decrease in serum potassium levels was associated with decreases in blood glucose levels (r = 0.151, p = 0.025). During severe hypoglycemia, median blood glucose levels, incidence of tachycardia (> 100 beats per minute) and severe hypertension (≥ 180/120 mmHg) were 30 mg/dL (range, 14 to 62) and 35 mg/dL (range, 10 to 69; p = 0.04), 18.8% and 7.2% (p = 0.02), and 20.8% and 10.2% (p = 0.05) in the hypokalemia and normokalemia groups, respectively.


CONCLUSIONS
During severe hypoglycemia, hypokalemia occurred in 21.9% of T2DM patients and was associated with tachycardia and severe hypertension. Therefore, the results suggest that severe hypoglycemia may increase cardiovascular events in T2DM.
Department of Internal Medicine, Saint Carollo Hospital, Suncheon, Korea.
Mi Yeon
MY
Kang
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced / Q000453:epidemiology; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D007004:Hypoglycemic Agents / Q000009:adverse effects; D007008:Hypokalemia / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012720:Severity of Illness Index; D013610:Tachycardia / Q000139:chemically induced / Q000453:epidemiology; D014882:Water-Electrolyte Balance / Q000187:drug effects
D015415:Biomarkers; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D011188:Potassium
Diabetes mellitus, type 2; Electrolytes; Hypokalemia; Severe hypoglycemia