Year : 2020 | Volume
: 11 | Issue : 3 | Page : 163--168
Predisposing factors of hypoglycemia in patients with type 2 diabetes mellitus presented with symptomatic hypoglycemia in a tertiary hospital of Bangladesh
Ajit K Paul1, A. B.M. Kamrul-Hasan2
1 Department of Endocrinology, Mainamoti Medical College, Comilla, Bangladesh
2 Department of Endocrinology, Mymensingh Medical College and Hospital, Mymensingh, Bangladesh
Background: Hypoglycemia is almost inevitable complication of diabetes treatment and the most important barrier in achieving tight glycemic control in diabetes patients. Objective: To describe characteristics of the patients with T2DM presenting with hypoglycemia and identify the predisposing factors of hypoglycemia in them. Materials and Methods: This cross-sectional study was conducted in a tertiary hospital of Bangladesh from January 2017 to March 2018. Venous plasma glucose was measured in all patients with T2DM presented with signs-symptoms of hypoglycemia, patients having biochemically confirmed hypoglycemia (venous plasma glucose <3.9 mmol/L) were finally selected for the study. A semi-structured data collection sheet was used to obtain the demographic and clinical data including hypoglycemic symptoms. Results: One hundred patients with T2DM were included in the study among whom 59% were female, 53% aged ≥60 years, 90% lived in rural and sub-urban areas, 60% had diabetes for ≥10 years, and 88% took insulin. Hypertension was the most common (45%) co-morbid condition followed by ischemic heart disease (28%). Adrenergic symptoms were present in the majority of the subjects and 62% lost consciousness before reaching the hospital. Their mean plasma glucose at presentation was 2.41 mmol/L (±0.48); mean HbA1c was 7.5% (±1.7) and 86% of them had eGFR <60 mL/min/1.73m2. Most of them (92%) received no education on hypoglycemia management and did not perform (95%) self-monitoring of blood glucose (SMBG). More than half had (51%) hypoglycemic episodes in the preceding 6 months and 28% were hospitalized for that. The meal-related factors (missed, inadequate or delayed meals) were the most common precipitating factors followed by drug overdose and excess exercise before hypoglycemia. Conclusion: Diabetes education emphasizing on appropriate lifestyle and dietary habit, and SMBG at recommended frequency are of utmost importance to prevent hypoglycemia.
Dr. A. B.M. Kamrul-Hasan
Department of Endocrinology, Mymensingh Medical College and Hospital, Mymensingh.
|How to cite this article:|
Paul AK, Kamrul-Hasan AB. Predisposing factors of hypoglycemia in patients with type 2 diabetes mellitus presented with symptomatic hypoglycemia in a tertiary hospital of Bangladesh.J Diabetol 2020;11:163-168
|How to cite this URL:|
Paul AK, Kamrul-Hasan AB. Predisposing factors of hypoglycemia in patients with type 2 diabetes mellitus presented with symptomatic hypoglycemia in a tertiary hospital of Bangladesh. J Diabetol [serial online] 2020 [cited 2020 Oct 24 ];11:163-168
Available from: https://www.journalofdiabetology.org/article.asp?issn=2078-7685;year=2020;volume=11;issue=3;spage=163;epage=168;aulast=Paul;type=0