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Colegio de Medicina Interna de México.

2014, Number 4

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Med Int Mex 2014; 30 (4)

Risk Factors Related to Severe Hypoglycemia Episodes in Diabetic Patients

Dehesa-López E, Manzanarez-Moreno I, Quintero-Pérez A

Language: Spanish
References: 28
Page: 407-418
PDF size: 465.07 Kb.


ABSTRACT

Background: Hypoglycemia is a frequent complication in patients with diabetes mellitus. Furthermore it has a negative impact on morbidity, mortality and quality of life of these patients.
Objective: To identify risk factors associated with episodes of severe hypoglycemia in patients with diabetes mellitus.
Material and method: A case-control study was performed including 58 patients with diabetes mellitus who were admitted to the emergency department with a diagnosis of severe hypoglycemia and 63 controls diabetic patients. Binary logistic regression was used to study the effect of clinical, demographic and laboratorial characteristics for severe hypoglycemia risk.
Results: Mean age was 63 ± 13 years, 66.1% (n = 80) were female and 95% had diabetes mellitus 2. Risk factors associated with severe hypoglycemia were: age with OR of 1.12 (95% CI 1.05-1.20; p = 0.01), administration of secretagogues with OR of 9.92 (95% CI 1.56-63.22; p = 0.02), administration of NPH insulin with OR of 131.99 (95% IC 8.5- 2,049.9; p = 0.01) and number of previous hypoglycemic events with OR 26.33 (95% IC 3.92-176.71; p = 0.01). Protective factors against severe hypoglycemia were: previous follow up by internal medicine doctor with OR of 0.07 (95% CI 0.01-0.35; p = 0.01) and previous follow up by endocrinologist with OR of 0.01 (95% CI 0.00-0.40; p = 0.02).
Conclusions: Risk factors for severe hypoglycemia were: age, previous hypoglycemic event, administration of NPH insulin and secretagogues. Interestingly, follow up by specialist doctor had an important role in reducing the risk of severe hypoglycemia.


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