Unmasking the challenges: hypoglycaemia and its effects on lymphoma hospitalisations

Jayalekshmi Jayakumar; Manasa Ginjupalli; Neha Fatima; Roy Arya Mariam

doi:10.1530/endoabs.109.P139

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Endocrine Abstracts (2025) 109 P139 | DOI: 10.1530/endoabs.109.P139

SFEBES2025 Poster Presentations Metabolism, Obesity and Diabetes (68 abstracts)

Unmasking the challenges: hypoglycaemia and its effects on lymphoma hospitalisations

Jayalekshmi Jayakumar ¹ , Manasa Ginjupalli ¹ , Neha Fatima ² & Arya Mariam Roy ³

Author affiliations

¹The Brooklyn Hospital Centre, Brooklyn, USA; ²North Middlesex Hospital, North Central London Deanery, London, United Kingdom; ³Ohio State University/The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, USA

Background: Hypoglycaemia in lymphoma is well-documented and can result from Warburg effect, pituitary/hepatic infiltration, chemotherapy side-effects, and glyceraldehyde-3-phosphate dehydrogenase overexpression. It disrupts cellular signalling pathways of growth and apoptosis, affects insulin secretion—which may support lymphoma cell survival—and impairs immune function, especially in T-cells and natural-killer cells. This complex interplay triggers inflammation, facilitating tumour progression. This study analyses the impact of hypoglycaemia on in-hospital outcomes of lymphoma.

Methods: The National-Inpatient-Sample-database (2016-2020) was utilised to identify lymphoma hospitalisations, stratified by hypoglycaemia prevalence based on ICD-10 codes. Categorical variables were analysed using chi-square tests, while continuous variables were assessed through t-tests, significance threshold set at P < 0.05. Multivariate regression analysis determined how hypoglycaemia affects lymphoma hospitalisations, adjusting for relevant confounders, sociodemographics and hospital characteristics.

Results: 1,485,770 lymphoma hospitalisations were identified, with 8,765 cases of hypoglycaemia. The mean age was similar for both groups (64.64 years for hypoglycemic and 64.47 years for non-hypoglycemic). Among those with hypoglycemia, 44.5% were females. Racial distribution was 63.05% white, 19.01% black, and 9.98% Hispanic (P < 0.001). Lymphoma patients with hypoglycemia experienced greater resource utilisation, with an average increased length of stay by 3.53 days (10.37 vs 6.84) and costs by $51,325 (139,353$ vs 88,028$). Multivariate regression analysis revealed worse outcomes for lymphoma hospitalisations with hypoglycemia, as detailed in the table.

Table 1. Impact of hypoglycaemia on lymphoma hospitalizations
	% with and without hypoglycaemia (p-value)	Adjusted-Odds-Ratio for confounders (95%-Confidence Interval)	P-value
Mortality	29.86, 4.74 (P < 0.001)	8.43 (7.33-9.69)	<0.001
Infections	32.57, 11.01 (P < 0.001)	3.70 (3.25-4.21)	<0.001
Metabolic-acidosis	37.82, 8.10 (P < 0.001)	6.61 (5.84-7.49)	<0.001
Tumour-lysis	10.49, 1.91 (P < 0.001)	5.66 (4.64-6.91)	<0.001
Disseminated-intravascular-coagulation	4.90, 0.45 (P < 0.001)	10.67 (8.14-13.98)	<0.001

Conclusion: Hypoglycaemia significantly impacts lymphoma hospitalisations, leading to increased resource utilisation, longer hospital stays, and poorer patient outcomes. Optimal management of hypoglycaemia in lymphoma patients is essential for high-value care and improving clinical results.