title: Severe hypoglycaemia during treatment with sulphonylureas in patients with type 2 diabetes in the Capital Region of Denmark.
abstract: OBJECTIVE
  Sulphonylureas (SU) are currently recommended as a well-established second line treatment in guidelines for type 2 diabetes (T2DM). In the Capital Region of Denmark 16,865 patients were given SU as part of their treatment of T2DM in 2010-2011. To what extent SU are associated with hospitalizations due to severe hypoglycaemic episodes, defined as episodes with a need for external assistance, was investigated. The prevalence and characteristics of these patients and potential risk factors were studied.
  
  
  METHODS
  ICD-10 diagnosis codes were used to identify patients hospitalized due to hypoglycaemia and T2DM for a period of 2 years (2010-2011). Inclusion criteria were T2DM, hospitalization due to hypoglycaemia and treatment with SU as monotherapy or in combination with other glucose-lowering drugs except insulin treatment.
  
  
  RESULTS
  We identified 161 patients fulfilling the inclusion criteria. Their mean age was 76 (53-97) years and 54% were males. Sixty percent of the patients had diabetic complications, including 19% with diabetic nephropathy. The major reason for severe hypoglycaemia was an unchanged dose of SU despite of a significant decline in food intake (45%). In 22% of the patients more than one reason was listed, most commonly a concomitant infection associated with decreased food intake and unchanged dose of SU.
  
  
  CONCLUSIONS
  The incidence of hospital admission-requiring severe hypoglycaemia in patients treated with SU was 0.48 episodes per 100 patient-years of SU-treated patients. It was mainly older patients with diminished food intake, excessive alcohol use or other medications, concomitant infection, and with diabetic complications.
authors.affiliation: Center for Diabetes Research, Department of Medicine, Gentofte Hospital, Denmark; Steno Diabetes Center, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Pilemann-Lyberg
authors.affiliation: Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital Hillerød, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
authors.forename: B
authors.initials: B
authors.lastname: Thorsteinsson
authors.affiliation: Department of Endocrinology, Hvidovre Hospital, Denmark.
authors.forename: O
authors.initials: O
authors.lastname: Snorgaard
authors.affiliation: Department of Endocrinology, Bispebjerg Hospital, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Zander
authors.affiliation: Department of Endocrinology, Herlev Hospital, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research - Section of Metabolic Genetics, Denmark; Steno Diabetes Center, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Vestergaard
authors.affiliation: Center for Diabetes Research, Department of Medicine, Gentofte Hospital, Denmark. Electronic address: michael.einar.roeder@regionh.dk.
authors.forename: M E
authors.initials: ME
authors.lastname: Røder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D013453:Sulfonylurea Compounds / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds
keywords: Characteristics of the patients; Precipitating factors; Prevalence of severe hypoglycaemia; Sulfonylurea use; When SU should be avoided