In-patients with Hypoglycemia among Diabetic Patients in Department of Medicine, Maharat Nakhon Ratchasima Hospital
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Abstract
Hypoglycemia is the important cause of admission of diabetic patients and it can also occur during the hospitalization. Aims: To describe the clinical characteristics of the diabetic patients who developed hypoglycemia before and during admission including their causes and the outcomes. Patients & Methods: This retrospective study reviewed the medical records from ICD-10 of in-patients with hypoglycemia among diabetic patients in Department of Medicine, Maharat Nakhon Ratchasima Hospital. We selected the patients three-month period that during showed the highest prevalence of hypoglycemia in the year 2010. Data collection included the clinical characteristics, the cause of hypoglycemia and discharge status. Results: Eighty-six diabetic patients with hypoglycemia at that time were enrolled. The first group was 55 patients with hypoglycemia at admission time and the second group was 31 patients with in-hospital hypoglycemia. Most of the first group were middle-aged females and had the history of poor intake, 60% of them had coma and drowsiness presentation. Most common co-existing illnesses were sepsis and renal failure. The oral hypoglycemic drugs and/or insulin caused hypoglycemia at admission in 64% of this group. For the second group, 32% of them were asymptomatic and 38% of them had drowsiness. The common causes of in-hospital hypoglycemia were infection and nothing per oral (NPO). Capillary blood sugar was monitored in all of the patients during hospitalization but 36% of the patients were given intravenous fluids without dextrose. The mortality rate was 30% in overall diabetic patients with hypoglycemia and the most common cause of death was severe sepsis. Conclusion: The most of diabetic patients with hypoglycemia at admission presented with coma or drowsiness. The common co-existing illnesses were sepsis and renal failure. The diabetic patient with in-hospital hypoglycemia were asymptomatic and could be detected with closed monitoring using capillary blood sugar. The common causes of in-hospital hypoglycemia were infection and not per oral.
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