ECEESPE2025 Poster Presentations Diabetes and Insulin (143 abstracts)
Understanding severe hypoglycaemia in diabetes mellitus: a retrospective analysis into risk factors, management and outcomes
Sara Abdi Osman 1 , Aqeelah Khatoon 1 , Haaziq Sheikh 1 , Sam Sherratt-Mayhew 1 , Faiz Ahmed 1 , Sanna Waheed 1 , Elysia Normanton 1 , Rajeev Raghavan 2 , Pratik Choudhary 3 , Punith Kempegowda 4 , 5 , Rachael Yip 1 , Team Dekode 1 & Amanda Ling Jie Yee 1
1University of Birmingham, Medical School, School of Medical Sciences, Birmingham, United Kingdom; 2New Cross Hospital, NHS Trust, Wolverhampton Diabetes Endocrine Centre, Wolverhampton, United Kingdom; 3University of Leicester, Diabetes Research Centre, Department of Population Health Sciences, University of Leicester, Leicester, United Kingdom; 4University of Birmingham, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom; 5University Hospitals Birmingham NHS Foundation Trust, Department of Diabetes and Endocrinology, Birmingham, United Kingdom
JOINT1239
Background: Severe hypoglycemia poses major complications for patients with diabetes mellitus (DM), varying from significant mortality risk to increased healthcare dependence.
Aims: This study aims to characterise the demographics, precipitating factors, and clinical outcomes of severe hypoglycemia episodes in DM patients, focusing on differences between inpatient and outpatients. This research seeks to inform targeted interventions to improve patient outcomes and reduce hospitalisations.
Methods: A retrospective analysis was conducted between October 2023 and July 2024 and involved 9 UK hospitals as part of the DEKODE hypoglycemia study. The exclusion criteria included cases of pre-diabetes (3), uncertain diagnosis (7) or non-DM cases (293). This study defined hypoglycaemia as per the International Hypoglycaemia Study Group (IHSG); excluding IHSG level 1 episodes, 1, 451 episodes were analyzed from 946 DM patients. Data included key patient demographics, DM type, treatments received, main precipitating factors, Charlson Comorbidity Index (CCI) and overall clinical outcomes. Results were analysed using Fisher’s test, with a significance level of P < 0. 05 being used.
Results: Among 1, 451 cases analyzed, 53. 1% occurred in females, with 72. 2% of patients of White ethnicity. The median age was 73 years, and the median CCI score was 6. Type 2 diabetes accounted for 68% of episodes, with insulin use reported in 79% of cases. Intercurrent illness was the most common precipitating factor (42. 1%), followed by fasting (39. 8%) and incorrect medication (18. 6%). Treatment methods also varied; oral glucose was used in 72. 6% of cases, dextrose in 43. 9%, and glucagon in 13. 8%. Severe cases requiring hospital or Intensive Treatment Unit admission occurred in 4. 4%, with a mortality rate of 5. 2%. Median glucose was 2. 3 mmol/l (IQR: 1. 9 - 2. 7), and the median hospital stay was 7 days (IQR: 2-17). Comparing inpatient and outpatient episodes (77. 1% vs 22. 9%), outpatient episodes showed higher rates of preceding cognitive impairment (72. 6% vs 50. 2%). Fasting was also the most common precipitating factor among outpatients (42. 9% vs. 29. 5%, P < 0. 0001) and with glucagon administered as a treatment more often to outpatients (45. 7% vs. 4. 6%, P < 0. 0001).
Conclusion: This study highlights the clinical diversity of hypoglycemia episodes, including precipitating factors, management, and outcomes, with notable differences between inpatients and outpatients. Future research should prioritise tailored interventions, such as patient education and medication review, to reduce hospitalisations and improve outcomes.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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