ECE2023 Eposter Presentations Late Breaking (91 abstracts)
Endocrinology Research Centre, Moscow, Russia
Introduction: Decreased glycemia in patients without diabetes mellitus (nondiabetic hypoglycemias; NDH) is a manifestation of severe diseases from endocrinopathies to malignant tumors. The most specific symptom of NDH is association of attack with the intake of carbohydrate-containing food. Hypoglycemia is usually manifested by neurological and mental disorders, and therefore, patients initially seek medical help not from an endocrinologist, but from psychiatrists and neurologists.
Objectives: To analyze the outcomes of the choice of primary specialists for medical care in patients with NDH.
Methods: anamnesis analysis of 431 patients with NDH aged 18-93 years.
Results: In 37% of patients with NDH, the correct diagnosis is delayed, among them 63% of patients have been initially observed by psychiatrists/neurologists.
Group | |||
1 | 2 | 3 | |
Initial seeking to a specialist | Endocrinologist | Psychiatrist/neurologist | General doctor, gastroenterologist, etc. |
n (%) | 274 (63,6) | 102 (23,7) | 55 (12,8) |
Duration (Mе (min-max)) of disease before verification* of NDH, months | 0,03 (0,03-80,00) | 84,00 (1,00-420,00) | 18,00 (0,03-180,00) |
р1-2,3<0,001; р2-3<0,001 | |||
Frequency of NDH verification* at the first seeking | 97% | 1% | 9% |
Frequency of hypoglycemic comas before NDH verification* | 0,4% | 20,6% | 5,5% |
р1-2<0,001; р2-3=0,012; р1-3=0,002 | |||
*or an assumption |
Conclusions: In a significant proportion of patients with NDH, the correct diagnosis is delayed, and most of these patients receive pathogenetically unreasonable treatment from psychiatrists/neurologists, which increases the risk of hypoglycemic coma. Thus, the alertness of doctors, especially psychiatrists/neurologists, regarding the timely detection of NDH is extremely important.