Differences in Clinical Outcomes between Patients with and without Hypoglycemia during Hospitalization: A Retrospective Study Using Real-World Evidence

Abstract

Background Some patients admitted to hospitals for glycemic control experience hypoglycemia despite regular meals and despite adhering to standard blood glucose control protocols. Different factors can have a negative impact on blood glucose control and prognosis after discharge. This study investigated risk factors for hypoglycemia and its effects on glycemic control during the hospitalization of patients in the general ward. Methods This retrospective study included patients who were admitted between 2009 and 2018. Patients were provided regular meals at fixed times according to ideal body weights during hospitalization. We categorized the patients into two groups: those with and those without hypoglycemia during hospitalization. Results Of the 3,031 patients, 379 experienced at least one episode of hypoglycemia during hospitalization (HYPO group). Hypoglycemia occurred more frequently particularly in cases of premixed insulin therapy. Compared with the control group, the HYPO group was older (61.0±16.8 years vs. 59.1±16.5 years, P =0.035), with more females (60.4% vs. 49.6%, P <0.001), lower body mass index (BMI) (23.5±4.2 kg/m 2 vs. 25.1±4.4 kg/m 2 , P <0.001), and higher prevalence of type 1 diabetes mellitus (6.1% vs. 2.6%, P <0.001), They had longer hospital stay (11.1±13.5 days vs. 7.6±4.6 days, P <0.001). After discharge the HYPO group had lower glycosylated hemoglobin reduction rate (−2.0%±0.2% vs. −2.5%±0.1%, P =0.003) and tended to have more frequent cases of cardiovascular disease. Conclusion Hypoglycemia occurred more frequently in older female patients with lower BMI and was associated with longer hospital stay and poorer glycemic control after discharge. Therefore, clinicians must carefully ensure that patients do not experience hypoglycemia during hospitalization.

Adherence to healthy lifestyle behaviors as a preventable risk factor for severe hypoglycemia in people with type 2 diabetes: A longitudinal nationwide cohort study

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Data Pseudonymization in a Range That Does Not Affect Data Quality: Correlation with the Degree of Participation of Clinicians

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Letter: Differences in Clinical Outcomes between Patients with and without Hypoglycemia during Hospitalization: A Retrospective Study Using Real-World Evidence (Diabetes Metab J 2020;44:555-65)

“…In the article entitled, "Differences in clinical outcomes between patients with and without hypoglycemia during hospitalization: a retrospective study using real-world evidence, " by Lee et al [9], the authors report an evaluation of the risk factors for and the effects of hypoglycemia. The risk factors for hypoglycemia during hospitalization were found to be old age, low body mass index, female sex, and the use of premix insulin.…”