Predisposing factors of hypoglycemia in patients with type 2 diabetes mellitus presented with symptomatic hypoglycemia in a tertiary hospital of 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 factor...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Journal of Diabetology |
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| Online Access: | http://www.journalofdiabetology.org/article.asp?issn=2078-7685;year=2020;volume=11;issue=3;spage=163;epage=168;aulast=Paul |
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| author | Ajit K Paul A. B.M. Kamrul-Hasan |
| author_facet | Ajit K Paul A. B.M. Kamrul-Hasan |
| author_sort | Ajit K Paul |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-19T17:23:32Z |
| format | Article |
| id | doaj.art-6bcdd3003743478bbdaf6f4336953340 |
| institution | Directory Open Access Journal |
| issn | 2078-7685 |
| language | English |
| last_indexed | 2024-12-19T17:23:32Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Diabetology |
| spelling | doaj.art-6bcdd3003743478bbdaf6f43369533402022-12-21T20:12:37ZengWolters Kluwer Medknow PublicationsJournal of Diabetology2078-76852020-01-0111316316810.4103/JOD.JOD_27_19Predisposing factors of hypoglycemia in patients with type 2 diabetes mellitus presented with symptomatic hypoglycemia in a tertiary hospital of BangladeshAjit K PaulA. B.M. Kamrul-HasanBackground: 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.http://www.journalofdiabetology.org/article.asp?issn=2078-7685;year=2020;volume=11;issue=3;spage=163;epage=168;aulast=Paultype 2 diabeteshypoglycemiainsulinlifestyle factorsdiabetes educationbangladesh |
| spellingShingle | Ajit K Paul A. B.M. Kamrul-Hasan Predisposing factors of hypoglycemia in patients with type 2 diabetes mellitus presented with symptomatic hypoglycemia in a tertiary hospital of Bangladesh Journal of Diabetology type 2 diabetes hypoglycemia insulin lifestyle factors diabetes education bangladesh |
| title | Predisposing factors of hypoglycemia in patients with type 2 diabetes mellitus presented with symptomatic hypoglycemia in a tertiary hospital of Bangladesh |
| title_full | Predisposing factors of hypoglycemia in patients with type 2 diabetes mellitus presented with symptomatic hypoglycemia in a tertiary hospital of Bangladesh |
| title_fullStr | Predisposing factors of hypoglycemia in patients with type 2 diabetes mellitus presented with symptomatic hypoglycemia in a tertiary hospital of Bangladesh |
| title_full_unstemmed | Predisposing factors of hypoglycemia in patients with type 2 diabetes mellitus presented with symptomatic hypoglycemia in a tertiary hospital of Bangladesh |
| title_short | Predisposing factors of hypoglycemia in patients with type 2 diabetes mellitus presented with symptomatic hypoglycemia in a tertiary hospital of Bangladesh |
| title_sort | predisposing factors of hypoglycemia in patients with type 2 diabetes mellitus presented with symptomatic hypoglycemia in a tertiary hospital of bangladesh |
| topic | type 2 diabetes hypoglycemia insulin lifestyle factors diabetes education bangladesh |
| url | http://www.journalofdiabetology.org/article.asp?issn=2078-7685;year=2020;volume=11;issue=3;spage=163;epage=168;aulast=Paul |
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