SFEBES2023 Poster Presentations Metabolism, Obesity and Diabetes (70 abstracts)
Inpatient hypoglycaemia in patients with diabetes and moderate/severe frailty is associated with prolonged length of stay
Eka Melson 1,2 , Hnin Lwin 1 , Mohamed Fazil 1 , Kevin Thottungal 1 , Anu Thomas 1 , Faseeha Aftab 1 , HayMar Tun 1 , Sadaf Saeed 1 , Meri Davitadze 3 , Alison Gallagher 1 & Kath Higgins 1
1University Hospitals of Leicester, Leicester, United Kingdom. 2University of Leicester, Leicester, United Kingdom. 3Clinic NeoLab, Tbilisi, Georgia
Introduction: National guidance states that people with diabetes and frailty require personalised targets and less aggressive treatments due to the limited evidence for benefits and the high risk of hypoglycaemia. Studies have shown a low rate of deintensification in this cohort of patients that may increase the risk of inpatient hypoglycaemia, contributing to morbidity and mortality. The audit aims to assess the frequency of inpatient hypoglycaemia and its association with length of stay in people with diabetes and moderate/severe frailty.
Methods: We retrospectively collected data on patients with diabetes and clinical frailty score (CFS) of ≥6 that were discharged from the medical unit in 2022. Data including patients’ baseline characteristics, their medications, number of inpatient hypoglycaemia (capillary blood glucose < 4mmol/l), and length of stay were collected. Multivariate regression was conducted using StataSE v1.7 to assess the association between patient factors, inpatient hypoglycaemia and the length of hospital stay.
Results: Four-hundred and thirty-six patients were included in our analysis [Age: 79.5 years (IQR=71-86). 52.1% (n=227/436) were women and the median CFS was 6 (IQR=6-7). 29.4% (n=128/436) of the admissions were due to falls. 17.2% (n=75/436) had mild/moderate hypoglycaemia during admission and 6.0% (n=26/436) had severe inpatient hypoglycaemia (capillary blood glucose < 3mmol/l). The median length of stay was 8 days (IQR=4-16 days). Adjusted for age, insulin use and CFS, Multivariate regression showed a positive association between the occurrence of any episode of inpatient hypoglycaemia and the length of stay [β=6.65, P<0.001].
Conclusion: This audit shows a high rate of inpatient hypoglycaemia in patients with diabetes and moderate/severe frailty. Inpatient hypoglycaemia is also associated with increased length of stay highlighting the importance of early review of HbA1c, medication history and pro-active deintensification when appropriate. Systems to identify high-risk inpatients allowing targeted specialist support should be developed and implemented where possible.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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