Risk factors for hypoglycemia in patients with type 2 diabetes, hospitalized in internal medicine wards: Findings from the FADOI-DIAMOND study. (May 2016)

• Record Type: Journal Article
• Authors: Borzì, V.; Frasson, S.; Gussoni, G.; Di Lillo, M.; Gerloni, R.; Augello, G.; Gulli, G.; Ceriello, A.; Solerte, B.; Bonizzoni, E.; Fontanella, A.
• Is Part Of: Diabetes research and clinical practice. Volume 115(2016)
• Page Start: 24
• Page End: 30
• Publication Date: 2016-05
• Subjects: Hypoglycemia -- Risk factors -- Internal medicine -- Length of hospitalization -- Insulin; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2016.01.020
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: Hypoglycemia is a potential risk in the management of patients suffering from type 2 diabetes (T2DM) and hospitalized in internal medicine units (IMUs). The aim of this analysis was to evaluate incidence of hypoglycemia and related risk factors in a group of patients admitted to IMUs. Methods: We used the FADOI-DIAMOND study carried out in 53 Italian IMUs. The DIAMOND design included two cross-sectional surveys interspersed with an educational program. In both phases each center reviewed the charts of the last 30 hospitalized patients with known T2DM ( n = 3167), including information about hypoglycemia during hospital stay. The association between occurrence of hypoglycemia and potential predictors was evaluated by means of a multivariable logistic regression analysis. Results: A total of 385 symptomatic hypoglycemic events were observed (rate = 12%). Advanced age, cognitive dysfunction, and nephropathy were associated with hypoglycemia. Hypoglycemia occurred in 19.4% of patients treated according to the insulin sliding-scale method versus 11.4% of patients treated with basal bolus ( p < 0.01). More patients with hypoglycemia received sulfonylureas versus the no-hypoglycemia group (28.3% versus 20.6%, p < 0.001). Significantly longer length of hospital stay and increased in-hospital mortality were found in the group with hypoglycemia compared with the no-hypoglycemia group (12.7 ± 10.9 versus 9.6 ± 6.5 days; 8.8% versus 4.8%, p < 0.01). Conclusions: Hypoglycemia in hospitalized patients with diabetes is associated with increased length of hospitalization and in-hospital mortality. Identification of patients at increased risk of hypoglycemia may be important for optimally adapting treatment and patient management.