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Hypoglycemia in inpatients with type 2 diabetes mellitus

DOI: https://doi.org/10.29296/25877305-2019-12-06
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N. Belyaeva, Candidate of Medical Sciences Volga Research Medical University, Nizhny Novgorod

Hypoglycemia is one of the most common adverse events in patients with type 2 diabetes mellitus (DM) and occurs more often than hyperglycemia-associated complications, especially among the elderly and patients with long-term DM. Every four emergency drug-related hospitalizations are associated with hypoglycemia; this rate is even higher in elderly patients. Severe hypoglycemia is strongly associated with injuries and the occurrence of ventricular arrhythmias, dementia, death, and worsens quality of life in patients. Treatment for hypoglycemia remains expensive. Severe hypoglycemia that is common in inpatients poses a significant threat to their health and requires systemic interventions for improving treatment outcomes.

type 2 diabetes mellitus
risk factors

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  1. American Diabetes Association. Standards of medical care in diabetes-2015 abridged for primary care providers // Clin. Diabetes. – 2015; 33 (2): 97–111. https://doi.org/10.2337/diaclin.33.2.97.
  2. Carey M., Boucai L., Zonszein J. Impact of hypoglycemia in hospitalized patients // Curr. Diab. Rep. – 2013; 13: 107–13. DOI: 10.1007/s11892-012-0336-x.
  3. Dedov I.I., Shestakova M.V., Aleksandrov A.A. i dr. Algoritmy spetsializirovannoj meditsinskoj pomoschi bol'nym saharnym diabetom (8-j vypusk) // Caharnyj diabet. – 2017; 20 (15): 1–121 [Dedov I.I., Shestakova M.V., Aleksandrov A.A., et al. Algorithms of Specialized Medical Care for Diabetes Mellitus Patients (8th edition) // Diabetes mellitus. – 2017; 20 (15): 1–121 (in Russ.)]
  4. Standards of Medical Care in Diabetes-2016: Summary of Revisions // Diabetes Care. – 2016; 39 (1): 4–5. https://doi.org/10.2337/dc16-S003.
  5. Workgroup on Hypoglycemia, American Diabetes Association Defining and reporting hypoglycemia in diabetes: a report from the American Diabetes Association Workgroup on Hypoglycemia // Diabetes Care. – 2005; 28 (5): 1245–9. DOI: 10.2337/diacare.28.5.1245.
  6. Seaquist E., Anderson J., Childs B. et al. American Diabetes Association; Endocrine Society. Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society // J. Clin. Endocrinol. Metab. – 2013; 98 (5): 1845–59. DOI: 10.1210/jc.2012-4127.
  7. Nicolucci A., Pintaudi B., Rossi M. et al. The social burden of hypoglycemia in the elderly // Acta Diabetol. – 2015; 52 (4): 677–85. DOI: 10.1007/s00592-015-0717-0.
  8. Seligman H., Bolger A., Guzman D. et al. Exhaustion of food budgets at month’s end and hospital admissions for hypoglycemia // Health Aff. (Millwood). – 2014; 33 (1): 116–23. DOI: 10.1377/hlthaff.2013.0096.
  9. Basu S., Berkowitz S., Seligman H. The monthly cycle of hypoglycemia: an observational claims-based study of emergency room visits, hospital admissions, and costs in a commercially insured population // Med. Care. – 2017; 55 (7): 639–45. DOI: 10.1097/MLR.0000000000000728.
  10. Rodriguez-Gutierrez R., Ospina N., McCoy R. et al. Hypoglycemia as a Quality Measure in Diabetes Study Group. Inclusion of hypoglycemia in clinical practice guidelines and performance measures in the care of patients with diabetes. // JAMA Intern. Med. – 2016; 176 (11): 1714–6. DOI: 10.1001/jamainternmed.2016.5046.
  11. Bonds D., Miller M., Dudl J. et al. Severe hypoglycemia symptoms, antecedent behaviors, immediate consequences and association with glycemia medication usage: secondary analysis of the ACCORD clinical trial data // BMC Endocr. Disord. – 2012; 12: 5–6. DOI: 10.1186/1472-6823-12-5
  12. Silbert R., Salcido-Montenegro A., Rodriguez-Gutierrez R. et al. Hypoglycemia Among Patients with Type 2 Diabetes: Epidemiology, Risk Factors, and Prevention Strategies // Curr. Diab. Rep. – 2018; 18 (8): 53–4. DOI: 10.1007/s11892-018-1018-0.
  13. Östenson C., Geelhoed-Duijvestijn P., Lahtela J. et al. Self-reported non-severe hypoglycaemic events in Europe // Diabet. Med. – 2014; 31 (1): 92–101. DOI: 10.1111/dme.12261.
  14. Ulmer B., Kara A., Mariash C. Temporal occurrences and reccurence patterns of hypoglycemia during hospitalization // Endocr. Pract. – 2015; 21: 501–7. DOI: 10.4158/EP14355.OR.
  15. Lee S. So much insulin, so much hypoglycemia // JAMA Intern Med. – 2014; 174 (5): 686–8. DOI: 10.1001/jamainternmed.2013.13307.
  16. Dendy J., ChockalingramV., Tirumalasetty N. et al. Identifying risk factors for severe hypoglycemia in hospitalized patients with diabetes // Endocr. Pract. – 2014; 20: 1051–6. DOI: 10.4158/EP13467.OR.
  17. McCoy R., Herrin J., Lipska K. et al. Recurrent hospitalizations for severe hypoglycemia and hyperglycemia among U.S. adults with diabetes // J. Diabetes Complications. – 2018; 32 (7): 693–701. DOI: 10.1016/j.jdiacomp.2018.04.007.
  18. McCoy R., Lipska K., Yao X. et al. Intensive Treatment and Severe Hypoglycemia Among Adults With Type 2 Diabetes // JAMA Intern. Med. – 2016; 176 (7): 969–78. DOI: 10.1001/jamainternmed.2016.2275.
  19. Karter A., Warton E., Lipska K. et al. Development and Validation of a Tool to Identify Patients With Type 2 Diabetes at High Risk of Hypoglycemia-Related Emergency Department or Hospital Use // JAMA Intern. Med. – 2017; 177 (10): 1461–70. DOI: 10.1001/jamainternmed.2017.3844.
  20. Krinsley J., Schultz M. Mild hypoglycemia is strongly associated with increased intensive care unit length of stay // Ann. Intensive Care. – 2011; 1: 49. DOI: 10.1186/2110-5820-1-49.
  21. Arabi Y., Tamim H., Rishu A. Hypoglycemia with intensive insulin therapy in critically ill patients: predisposing factors and association with mortality. // Crit. Care Med. – 2009; 37 (9): 2536–44. Doi: 10.1097/CCM.0b013e3181a381ad.
  22. Akirov A., Grossman A., Shochat T. et al. Mortality Among Hospitalized Patients With Hypoglycemia: Insulin Related and Noninsulin Related // J. Clin. Endocrinol. Metab. – 2017; 102 (2): 416–24. DOI: 10.1210/jc.2016-2653.
  23. Stahn A., Pistrosch F., Ganz X. et al. Relationship between hypoglycemic episodes and ventricular arrhythmias in patients with type 2 diabetes and cardiovascular diseases: silent hypoglycemias and silent arrhythmias // Diabetes Care. – 2014; 37 (2): 516–20. DOI: 10.2337/dc13-0600.
  24. Whitmer R., Karter A., Yaffe K. et al. Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus // JAMA. – 2009; 301 (15): 1565–72. DOI: 10.1001/jama.2009.460.
  25. McCoy R., Van Houten H., Ziegenfuss J. et al. Increased mortality of patients with diabetes reporting severe hypoglycemia // Diabetes Care. – 2012; 35 (9): 1897–901. DOI: 10.2337/dc11-2054.
  26. Vriesendorp T., DeVries H., van Santen S. et al. Evaluation of short-term consequences of hypoglycemia in an intensive care unit // Crit. Care Med. – 2006; 34: 2714–8. DOI: 10.1097/01.CCM.0000241155.36689.91.
  27. Bar-Dayan Y., Wainstein J., Schorr L. et al. Hypoglycemia – simplifying the ways to predict an old problem in the general ward // Eur. J. Intern. Med. – 2018; 2 (8): 3–5. https://doi.org/10.1016/j.ejim.2018.10.007
  28. Samojlova Ju.G., Rotkank M.A., Zhukova N.G. i dr. Variabel'nost' glikemii u patsientov s saharnym diabetom 1-go tipa: svjaz' s kognitivnoj disfunktsiej i dannymi magnitno-rezonansnyh metodov issledovanija // Problemy endokrinologii. – 2018; 64 (5): 286–91 [Samoilova I.G., Rotkank M.A., Zhukova N.G. et al. Variability of glycemia in patients with type 1 diabetes mellitus: the relationship with cognitive dysfunction and the results of magnetic resonance imaging // Problems of endocrinology. – 2018; 64 (5): 286–91 (in Russ.)]. https://doi.org/10.14341/probl9589.
  29. Samojlova Ju.G., Rotkank M.A., Zhukova N.G. i dr. Markery kognitivnyh narushenij i variabel'nost' glikemii u patsientov s saharnym diabetom 1-go tipa // Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. – 2018; 118 (4): 48–51 [Samoilova Yu.G., Rotkank M.A., Zhukova N.G. et al. Markers for cognitive impairments and variability of glycaemia in patients with type 1 diabetes mellitus // S.S. Korsakov Journal of Neurology and Psychiatry = Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. – 2018; 118 (4): 48–51 (in Russ.)]. https://doi.org/10.17116/jnevro20181184148-51.
  30. Yeh J., Sung S., Huang H. et al. Hypoglycemia and risk of vascular events and mortality: a systematic review and meta-analysis // Acta Diabetol. – 2016; 53 (3): 377–92. DOI: 10.1007/s00592-015-0803-3.
  31. Mattishent K., Loke Y. Meta-analysis: Association between hypoglycaemia and serious adverse events in older patients // J. Diabetes Complications. – 2016; 30 (5): 811–8. DOI: 10.1016/j.jdiacomp.2016.03.018.
  32. Araque K., Kadayakkara D., Gigauri N. et al. Reducing severe hypoglycaemia in hospitalised patients with diabetes: Early outcomes of standardised reporting and management // BMJ Open Qual. – 2018; 7 (2): 4–7. DOI: 10.1136/bmjoq-2017-000120.
  33. Meulstee M., Whittemore R., Watts S. Development of an educational program on prevention of hypoglycemic events among elderly veterans with type 2 diabetes // Diabetes Educ. – 2015; 41 (6): 690–7. DOI: 10.1177/0145721715606805.
  34. Meurer W., Tolles J. Logistic regression diagnostics: understanding how well a model predicts outcomes // JAMA. – 2017; 317 (10): 1068–9. DOI: 10.1001/jama.2016.20441.
  35. Rondags S., de Wit M., van Tulder M. et al. HypoAware – a brief and partly web-based psycho-educational group intervention for adults with type 1 and insulin-treated type 2 diabetes and problematic hypoglycaemia: design of a cost-effectiveness randomised controlled trial // BMC Endocr. Disord. – 2015; 15: 43–4. DOI: 10.1186/s12902-015-0035-0.
  36. Tseng C., Soroka O., Maney M. et al. Assessing potential glycemic overtreatment in persons at hypoglycemic risk // JAMA Intern. Med. – 2014; 174 (2): 259–68. DOI: 10.1001/jamainternmed.2013.12963.
  37. McCoy R., Lipska K., Yao X. et al. Intensive treatment and severe hypoglycemia among adults with type 2 diabetes // JAMA Intern. Med. – 2016; 176 (7): 969–78. DOI: 10.1001/jamainternmed.2016.2275.
  38. Rodriguez-Gutierrez R., Lipska K., McCoy R. et al. Hypoglycemia as a Quality Measure in Diabetes Study Group .Hypoglycemia as an indicator of good diabetes care // BMJ. – 2016; 35 (2): 10–4. DOI: 10.1001/jamainternmed.2016.5046.