Endocrine Abstracts

Introduction: Hypoglycaemia is the most serious side effect inherent in the search for good glycemic control in diabetic patients, which can be fatal and often cause significant physical and psychosocial morbidity.

Aim: The aim of our study was to estimate the frequency of hypoglycaemia and to determine the factors associated with their occurrence.

Methods: This was a retrospective descriptive study. The study is conducted in 200 diabetic patients at the National Institute of Nutrition of Tunis. Patients underwent careful clinical examination and a standard biological assessment.

Results: We included 200 patients with type 2 diabetes. The mean age was 52.78±14.2 years, 58.5% were female. The mean duration of diabetes progression was 12±8.41 years. Mean HbA1c was 9.9±2.09%. The circumstances of discovery of hypoglycemia were a fictitious dose of insulin therapy in 8% of cases, unstable diabetes in 36%, adrenal insufficiency in 20%, insulin overdose in 18% and in 13% of cases are due a lack of therapeutic education (skipping meals, inadequate physical activity, injection of lipodystrophies, poor management of syringes), and of undetermined origin in 5% of cases. The clinical signs are represented in all patients by neurovegetative signs. Neuroglucopenic symptoms were present in 67% of our patients. Blood glucose levels at the time of hypoglycemia ranged from 0.13 to 0.55 g/l. The immediate evolution after resuscitation and resuscitation was marked by the recovery of the state of consciousness in all our patients.

Conclusion: Hypoglycemia is a diagnostic and therapeutic emergency because of the risk of irreversible neurological damage. It is most often iatrogenic hypoglycaemia caused by the hypoglycemic treatment of the diabetic patient but other causes are possible and to search if necessary. Several factors are associated with an increased risk of hypoglycaemia in diabetics, which leads to caution in determining treatment.