Predisposing factors for hypoglycaemia in the emergency department

Abstract

Objective Hypoglycaemia is a common complication of diabetes mellitus. Previous studies suggest that hypoglycaemic episodes may occur with other comorbidities, influencing the outcome of recovery. Recognising the predisposing factors for hypoglycaemic episodes in the emergency department is important. Therefore, we investigated the characteristics of and predisposing factors for hypoglycaemia in the emergency department. Methods Data from 186 patients were retrospectively collected from a medical centre in northern Taiwan. We divided the patients into the advanced-age group (132 patients) and the younger group (54 patients). Associated data collected for statistical analysis included vital signs on arrival, first measured blood glucose level, laboratory results, related comorbidities, length of hospital stay, and survival to discharge. Results Hypoglycaemia was more frequently observed in women in the advanced-age group than in the younger group. Tachycardia and elevated systolic blood pressure were less predominant in the advanced-age group than younger group. More patients in the advanced-age group had concurrent infection, and more patients in the younger group had liver dysfunction, elevated liver enzymes, liver cirrhosis, and concurrent stroke. Conclusions Closer attention should be paid to the possibility of infection in patients of advanced age. Liver disease and stroke need to be ruled out in younger patients.

High fever or hypotension predicts non‐hypoglycemia in patients with impaired consciousness in prehospital settings

“…Evaluating the known risk factors for hypoglycemia, such as a history of diabetes mellitus and renal dysfunction, is useful in predicting its presence 22–24 . Approximately 69–85% of hypoglycemic patients have a history of diabetes 2,25 . The findings in this study indicate that hypoglycemia is unlikely but cannot be excluded when patients have vital signs of sBP <100 mmHg and BT ≥38°C.…”

“…[22][23][24] Approximately 69-85% of hypoglycemic patients have a history of diabetes. 2,25 The findings in this study indicate that hypoglycemia is unlikely but cannot be excluded when patients have vital signs of sBP <100 mmHg and BT ≥38°C. It is important to understand the risk factors for hypoglycemia, but impaired consciousness makes it difficult to obtain clinical information from patients, and approximately 60% of hypoglycemic patients have a confirmed history of diabetes in prehospital settings.…”

The burden of diabetic emergencies on the resuscitation area of a district-level public hospital in Cape Town

“…Infection was deemed to be the precipitant factor in 40% of patients which confirms the high rate of infection in patients presenting with diabetic emergencies [22] , 23. , [24] . This further indicates the need for the diligent search for infection, which should include cultures of blood, urine and pulmonary specimens.…”

Hepatocrinology

“…Hypoglycemia is commonly encountered in patients with advanced cirrhosis, especially if a concurrent infection is present [ 51 , 52 ]. Hypoglycemia occurs in up to 40% of cases of acute liver failure and is associated with increased mortality [ 53 , 54 ].…”