Endocrine Abstracts

Introduction: Severe hypoglycemia is defined as an episode that requires the assistance of another person in order to correct it. Most of the costs associated with hypoglycemia in diabetes mellitus patients are the result of severe episodes, when treated by health care professionals. In our country there are few studies regarding the epidemiology of episodes of hypoglycemia evaluated in the pre-hospital care setting.

Methods: We retrieved all episodes of hypoglycemia evaluated by a pre-hospital care unit of a reference hospital between 1st January and 31st March 2010, and recorded demographic data and the medication used.

Results: We recorded 37 episodes of severe hypoglycemia (4.7% of a total 793 emergency episodes). Thirteen episodes (35.1%) were nocturnal. At arrival, the mean Glasgow Coma Scale was 8.0±4.71 and the mean capillary glucose was 32.0±14.96 mg/dl (1.8±0.83 mmol/l). The mean age of patients was 60.7±18.36 years (minimum 27 – maximum 84 years) and 10 (27.8%) patients were male. Of 31 patients with available information regarding type of diabetes, 11 (35.5%) had type 1 diabetes and 20 (64.5%) had type 2 diabetes. Of 21 patients with data on diabetes treatment, 21 (65.6%) were treated with insulin, 6 (18.8%) with oral medication and 5 (15.6%) with combined insulin and oral medication therapy. Of 11 patients treated with oral agents, 6 (54.5%) were using sulphonylureas. Seventeen episodes (45.9%) resulted in the transportation of the patient to the emergency room, 14 of which involved type 2 diabetics.

Conclusions: Severe hypoglycemia is a frequent cause of emergency calls and evaluation by a pre-hospital care unit. It occurs in type 1 and type 2 diabetics alike, as well as individuals of all age groups. Less than half of episodes result in transportation to an emergency department and type 1 diabetics are more likely to maintain an ambulatory treatment plan.