Characteristics of the type 2 diabetic patients with hypoglycemia in a tertiary referral hospital

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Satilmis Bilgin
Gulali Aktas
Ozge Kurtkulagi
Burcin M. Atak
Gizem Kahveci
Muhammed E. Demirkol
Tuba T. Duman


Background. Hypoglycemia is an important complication of the treatment of type 2 diabetes mellitus, which constitutes a barrier in stringent diabetic control. Beside it constitutes nearly 10 % of emergency department admissions that caused by adverse drug events, it may also increase morbidities and mortality by inducing, cardiac arrhythmias, neurological impairment and ischemic events. Hypoglycemia is the most common side effect of insulin treatment, however, oral antidiabetic agents may also induce hypoglycemic complications. In present retrospective study, we purposed to observe general characteristics and laboratory data of the type 2 diabetic patients whom presented with mild or moderate/severe hypoglycemia. Materials and methods. Patients with type 2 diabetes mellitus whom presented to our institution with hypoglycemia between January 2019 and January 2020 were retrospectively analyzed. General characteristics and laboratory data of the subjects recorded. Patients grouped into two groups, group I consisted of subjects with mild hypoglycemia and group II consisted of patients with moderate/severe hypoglycemia. Data of the subjects in groups I and II were compared. Results. There were 15 subjects in group I and 23 in group II. HbA1c and other laboratory markers were not significantly different in study groups. Similarly diabetes duration and anti-diabetic treatment were not significantly different in study groups. The rate of geriatric patients was significantly higher in group II compared to group I (p = 0.04). Conclusions. Subjects with moderate/severe hypoglycemia tend to be more frequently in geriatric age and HbA1c not correlates with the degree of the hypoglycemia. Since neither duration of diabetes, nor anti-diabetic treatment were associated with the severity of the hypoglycemia, each case should be evaluated individually to prevent further episodes which could increase morbidity and mortality in diabetic population.

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How to Cite
Bilgin, S., G. Aktas, O. Kurtkulagi, B. M. Atak, G. Kahveci, M. E. Demirkol, and T. T. Duman. “Characteristics of the Type 2 Diabetic Patients With Hypoglycemia in a Tertiary Referral Hospital”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 17, no. 6, Dec. 2021, pp. 472-6, doi:10.22141/2224-0721.17.6.2021.243209.
Original Researches


Freeland B. Hypoglycemia in Diabetes Mellitus. Home Healthc Now. 2017 Sep;35(8):414-419. doi: 10.1097/NHH.0000000000000584.

Geller AI, Shehab N, Lovegrove MC, et al. National estimates of insulin-related hypoglycemia and errors leading to emergency department visits and hospitalizations. JAMA Intern Med. 2014;174(5):678-86. doi: 10.1001/jamainternmed.2014.136.

Tourkmani AM, Alharbi TJ, Rsheed AMB, et al. Hypoglycemia in Type 2 Diabetes Mellitus patients: A review article. Diabetes Metab Syndr. 2018 Sep;12(5):791-794. doi: 10.1016/j.dsx.2018.04.004.

Lee SJ. So much insulin, so much hypoglycemia. JAMA Intern Med. 2014 May;174(5):686-8. doi: 10.1001/jamainternmed.2013.13307.

Introduction: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021 Jan;44(Suppl 1):S1-S2. doi: 10.2337/dc21-Sint.

Hsu PF, Sung SH, Cheng HM, et al. Association of clinical symptomatic hypoglycemia with cardiovascular events and total mortality in type 2 diabetes: a nationwide population-based study. Diabetes Care. 2013 Apr;36(4):894-900. doi: 10.2337/dc12-0916.

Unger J. Educating patients about hypoglycemia prevention and self-management. Clinical Diabetes 2013;31(4):179-188. doi: 10.2337/diaclin.31.4.179.

Cryer PE. Hypoglycemia-Associated Autonomic Failure in Diabetes: Maladaptive, Adaptive, or Both? Diabetes. 2015 Jul;64(7):2322-3. doi: 10.2337/db15-0331.

Weinstock RS, Xing D, Maahs DM, et al; T1D Exchange Clinic Network. Severe hypoglycemia and diabetic ketoacidosis in adults with type 1 diabetes: results from the T1D Exchange clinic registry. J Clin Endocrinol Metab. 2013 Aug;98(8):3411-9. doi: 10.1210/jc.2013-1589.

Cryer PE. Severe hypoglycemia predicts mortality in diabetes. Diabetes Care. 2012 Sep;35(9):1814-6. doi: 10.2337/dc12-0749.

Writing Group for the DCCT/EDIC Research Group, Orchard TJ, Nathan DM, Zinman B, et al. Association between 7 years of intensive treatment of type 1 diabetes and long-term mortality. JAMA. 2015 Jan 6;313(1):45-53. doi: 10.1001/jama.2014.16107.

Cryer PE. Glycemic goals in diabetes: trade-off between glycemic control and iatrogenic hypoglycemia. Diabetes. 2014 Jul;63(7):2188-95. doi: 10.2337/db14-0059.

Cryer PE. Mechanisms of hypoglycemia-associated autonomic failure and its component syndromes in diabetes. Diabetes. 2005 Dec;54(12):3592-601. doi: 10.2337/diabetes.54.12.3592.

Nathan DM. Diabetes: Advances in Diagnosis and Treatment. JAMA. 2015 Sep 8;314(10):1052-62. doi: 10.1001/jama.2015.9536.

Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015 Jan;38(1):140-9. doi: 10.2337/dc14-2441.

Lipska KJ, Krumholz H, Soones T, Lee SJ. Polypharmacy in the Aging Patient: A Review of Glycemic Control in Older Adults With Type 2 Diabetes. JAMA. 2016 Mar 8;315(10):1034-45. doi: 10.1001/jama.2016.0299.

Yu S, Fu AZ, Engel SS, Shankar RR, Radican L. Association between hypoglycemia risk and hemoglobin A1C in patients with type 2 diabetes mellitus. Curr Med Res Opin. 2016 Aug;32(8):1409-16. doi: 10.1080/03007995.2016.1176017.

Sircar M, Bhatia A, Munshi M. Review of Hypoglycemia in the Older Adult: Clinical Implications and Management. Can J Diabetes. 2016 Feb;40(1):66-72. doi: 10.1016/j.jcjd.2015.10.004.

Frier BM. Hypoglycaemia in diabetes mellitus: epidemiology and clinical implications. Nat Rev Endocrinol. 2014 Dec;10(12):711-22. doi: 10.1038/nrendo.2014.170.

Meneilly GS, Elliott T. Metabolic alterations in middle-aged and elderly obese patients with type 2 diabetes. Diabetes Care. 1999 Jan;22(1):112-8. doi: 10.2337/diacare.22.1.112.

Ligthelm RJ, Kaiser M, Vora J, Yale JF. Insulin use in elderly adults: risk of hypoglycemia and strategies for care. J Am Geriatr Soc. 2012 Aug;60(8):1564-70. doi: 10.1111/j.1532-5415.2012.04055.x.

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