Endocrine Abstracts

Introduction: Hypoglycemia is a major obstacle to glycemic control in type 1 diabetics. Approximately two episodes of symptomatic hypoglycemia occur weekly in type 1 diabetic and this risk increases with the duration of diabetes and the strict control¹. The aim of this study was to identify the most frequent etiologies of hypoglycemia in hospitalized type 1 diabetic patients.

Patients and Methods: This is a retrospective descriptive study that involved 28 type 1 diabetic patients hospitalized for hypoglycemia in the endocrinology department of the Taher Sfar University Hospital of Mahdia between 2011 and 2022.

Results: The average age of our patients was of 34.44±13.88 years. The patients were divided into 6 men and 22 women. The average duration of diabetes was of 11.7 ±7.45 years. The mean glycated hemoglobin in our patients was of 9.46% ±2.68. The average frequency of hypoglycemia was 3 episodes per week. Severe hypoglycemia was present in ten cases. Several interrelated factors were often incriminated in the same patient. Hypoglycemia was attributed to poor education in 13 patients: 6 cases of insulin dose error, 6 cases of dietary error, 6 cases of injection in lipodystrophic areas. Two cases of hypoglycemia were attributed to severe renal failure. Hypoglycemia secondary to Addison’s disease was diagnosed in 15 patients. A context of a malabsorption syndrome due to celiac disease has been demonstrated in three patients. Fake hypoglycemia was the cause of hypoglycemia in one patient.

Discussion and Conclusion: Hypoglycemia is a dread for any caregiver because of its neurocognitive impact on the quality of life and carbohydrate balance of type 1 diabetics. Rigorous etiological research is needed, requiring sometimes hospitalization and treatment reevaluation. In the literature, the occurrence of Addison’s disease in type 1 diabetics is rare with a prevalence of 1.2%². The explanation of the higher prevalence of Addison’s disease in our population need to be explored.

References: 1. “Hypoglycemia in Type 1 Diabetes | Diabetes | American Diabetes Association.2. “Addison’s disease in type 1 diabetes presenting with recurrent hypoglycemia | Postgraduate Medical Journal3. M. Alsahli and J. E. Gerich, “Hypoglycemia in Patients with Diabetes and Renal Disease.