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Internal and Emergency Medicine

, Volume 13, Issue 3, pp 343–350 | Cite as

Predictors of hypoglycemia in hospitalized patients with diabetes mellitus

  • Amit AkirovEmail author
  • Oren Amitai
  • Hiba Masri-Iraqi
  • Talia Diker-Cohen
  • Tzipora Shochat
  • Yoav Eizenberg
  • Ilan Shimon
IM - ORIGINAL

Abstract

Hypoglycemia is common among hospitalized patients with diabetes mellitus (DM), and is associated with increased morbidity and mortality. Identify pre-admission risk factors associated with in-hospital hypoglycemia. Historical prospectively collected data of adult DM patients hospitalized to medical wards between 2011 and 2013. Hypoglycemia and serious hypoglycemia were defined as at least one blood glucose measurement ≤ 70 and < 54 mg/dl, respectively, during hospitalization. The primary outcome was in-hospital hypoglycemia. The cohort included 5301 patients (mean age 73 ± 13 years, 51% male), including 792 patients (15%) with hypoglycemia, among them 392 patients (7%) with serious hypoglycemia. Patients with hypoglycemia or serious hypoglycemia during hospitalization were older, compared to patients without hypoglycemia and more likely to have chronic renal failure and cerebrovascular disease. Malignancy and female gender were risk factors for hypoglycemia, but not for serious hypoglycemia, while congestive heart failure was associated with increased risk only for serious hypoglycemia. Diabetes mellitus’ duration over 10 years was associated with an almost threefold increased risk for hypoglycemia, compared to DM duration less than a year. Insulin treatment and glycated hemoglobin > 9% were also more common in patients with hypoglycemia. Insulin treatment was associated with a fourfold increase in the risk for hypoglycemia among all glycated hemoglobin categories. Our results identified several risk factors for in-hospital hypoglycemia in patients with DM. These findings may lead to appropriate monitoring and early intervention to prevent hypoglycemia and to reduce morbidity and mortality associated with in-hospital hypoglycemia.

Keywords

Diabetes mellitus Hospitalization Hospital care Hypoglycemia 

Notes

Acknowledgements

The authors have no conflicts of interest to disclose. The authors received no external funding for this study. A.A. had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Author contributions

AA substantial contributions to conception and design, acquisition of data or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content, final approval of the version to be published. OA substantial contributions to conception and design, acquisition of data or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content, final approval of the version to be published. HMI substantial contributions to conception and design, acquisition of data or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content, final approval of the version to be published. TDC substantial contributions to conception and design, acquisition of data or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content, final approval of the version to be published. TS substantial contributions to conception and design, acquisition of data or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content, final approval of the version to be published. IS substantial contributions to conception and design, acquisition of data or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content, final approval of the version to be published.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of retrospective study formal consent is not required.

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Copyright information

© SIMI 2018

Authors and Affiliations

  1. 1.Institute of EndocrinologyRabin Medical Center, Beilinson HospitalPetach TikvaIsrael
  2. 2.Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
  3. 3.Internal Medicine ABeilinson HospitalPetach TikvaIsrael
  4. 4.Statistical Consulting UnitRabin Medical Center, Beilinson HospitalPetach TikvaIsrael
  5. 5.Tel Aviv-Jaffa District Clalit Health ServicesTel AvivIsrael

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