Endocrine Abstracts

Achieving glycemic targets is crucial in the management of diabetes mellitus. Insulin is the most effective hypoglycemic treatment for diabetes but its use can be associated with a risk of hypoglycemia.

The aim of this study is to specify risk factors of hypoglycemia in insulin-treated patients.

Patients and methods: This transversal study included 69 patients. They were females in 49.4% of cases (n=41). Mean age was 52 years (14 –77). Diabetes was a type 2 diabetes in 65.2% of cases (n=45), a type 1 in 24.6% (n=17) and a secondary diabetes in 10.1% (n=7). Mean duration of diabetes was 13.9 years (2–32). Mean HBA1c was 10.9% (6.7 to 17.7%). Mean insulin dose was 0.79 IU/kg per day (0.14–1.7). All patients had a normal renal function.

Results: Hypoglycemia occurred in 81.2% of patients. Mean frequency of moderate and severe hypoglycemia were respectively 14.8 and 3.5 per month. No correlation was found between gender and type of diabetes on one hand and the occurrence of hypoglycemia on the other hand. No difference in daily insulin doses and number of daily injections was observed between patients with and without hypoglycemia. Lipodystrophies and injections into lipodystrophies were more frequent in patients with hypoglycemia but with no significant difference (P=0.08). Occurrence of hypoglycemia was negatively correlated to education for the technique of insulin injection (P=0.086) and positively correlated to duration of diabetes (P=0.012) and to duration of treatment with insulin (P<0.001).

Conclusion: Hypoglycemia in insulin-treated patients is frequent. Long progression period of diabetes and the lack of education concerning insulin injections seem to be major risk factors of hypoglycemia.