Endocrine Abstracts

Introduction: Hypoglycemia is a major limiting factor in intensive glucose control in diabetes mellitus. Its incidence has been increasing with the demand for intensive therapy for the prevention of the diabetic chronic complications. There are few studies in our country regarding the evaluation of hypoglycemia in the emergency room (ER).

Objective: To characterize severe hypoglycemia episodes and patient features in individuals admitted to the ER.

Methods: We obtained data regarding hypoglycemia episodes evaluated in the ER of our hospital between 1st January and 31st March 2010. We recorded the demographic and clinical data of the patients and destination after discharge.

Results: We recorded 61 episodes of severe hypoglycemia – 0.16% of total ER episodes. Mean glycemia at admission was 103.3±80.52 mg/dl0 (excluding 1 episode with Low). It is of notice that in 30 episodes (49.2%), the patients arrived to the ER hypoglycemic (1 Low; average 44.0±16.38 mg/dl). Of 59 patients evaluated, 28 (47.5%) were male. The mean age of the patients was 68.0±15.26 years. Five (8.5%) patients had type 1 diabetes mellitus, 48 (81.4%) had type 2 diabetes mellitus and 6 (10.2%) had other types of diabetes. Regarding the type of diabetes therapy, 21 (35.2%) patients were only oral medication treated, 30 (50.8%) were only insulin treated and 8 (13.6%) were treated with oral agents and insulin association. Nineteen (31.1%) patients were admitted to the ward. Of the total of patients, 17 died, on average, 13 months after the episode.

Conclusion: Among the patients evaluated for severe hypoglycemia in the ER, there is a higher prevalence of type 2 diabetics, older age and insulin treated individuals. This study reveals serious deficiencies in the evaluation and treatment of severe hypoglycemia in the pre-hospital emergency care. It is essential to improve the evaluation and treatment of severe hypoglycemia in the latter setting.