Hypoglycemia in Hospitalized Patients Linked to Increased Mortality Risk

Spontaneous and insulin-related hypoglycemia is common among hospitalized patients with and without diabetes mellitus (DM). The definition of hypoglycemia in hospitalized patients is poorly defined and thus the true prevalence of hypoglycemia during hospitalization is variable.

One complication of diabetes, hypoglycemia, occurs most often in people taking medications to manage their blood sugar. These treatments can raise insulin levels too high, which can in turn cause blood glucose levels to drop too low. Hypoglycemia can be dangerous and, depending on the severity, can lead to various symptoms, including dizziness, confusion, anxiety, seizure or loss of consciousness.

A team of medical scientists at the Rabin Medical Center (Petah Tikva, Israel) conducted a study in a large 1,300-bed university-affiliated tertiary medical center collected historical prospectively observational data which were extracted from the medical records of all patients admitted for any cause to the hospital’s medical wards between January 1, 2011 and December 31, 2013. This study included nearly 3,000 patients with hypoglycemia, defined as blood glucose levels lower than 70 mg/dL.

The team found that for patients with hypoglycemia, 31.9% had died at the end of the follow-up period. Mortality risk was higher in insulin-treated patients with moderate hypoglycemia (40-70 mg/dL), compared to patients without insulin treatment with similar glucose values. However, with severe hypoglycemia of less than 40 mg/dL, the increase in mortality risk was similar with insulin-related and non-insulin related hypoglycemia. The c cause of admission did not affect the association between glucose levels and mortality. Almost half the patients with hypoglycemia during hospitalization did not have pre- existing DM (1,452/2,947 patients, 49%). However, most of the patients with severe hypoglycemia had pre-existing DM (236/342 patients, 69%).

Amit Akirov, MD, the study senior author, said, “Hypoglycemia is common among hospitalized patients with and without diabetes mellitus. Our findings suggest that hypoglycemia, whether insulin-related or non-insulin related, is associated with short- and long-term mortality risk. These data are a timely reminder that hypoglycemia of any cause carries the association with increased mortality.” The study was published on November 17, 2016, in the Journal of Clinical Endocrinology & Metabolism.

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