EYES2024 ESE Young Endocrinologists and Scientists (EYES) 2024 Diabetes, Obesity and Metabolism (13 abstracts)
The characteristics of 541 severe hypoglycaemia’s presentation and management underscore the need for improved services: pilot data from DEKODE hypoglycaemia study
Aqeelah Khatoon 1 , Aditya Bal 1 , Ahmed Iqbal 2 , Amanda Ling Jie Yee 1 , Charles Page 1 , Kalyaani Persad 1 , Mariam Idrissi 1 , Ozge Ozturk 3 , Punith Kempegowda 4 & Sam Sherratt Mayhew 1
1University of Birmingham Medical School, Birmingham, United Kingdom; 2Department of Oncology & Metabolism, University of Sheffield & Sheffield Teaching Hospitals, Sheffield, United Kingdom; 3Good Hope Hospital, Birmingham, United Kingdom; 4Institute of Applied Health Research, University of Birmingham, United Kingdom
Introduction: Clinically significant hypoglycaemia, defined by blood glucose levels below 3 mmol/l (level 2) or requiring third-party assistance (level 3), poses significant risks for individuals with diabetes. However, limited information exists regarding their characteristics, management, and outcomes. The objective was to explore the characteristics, precipitating factors, and outcomes of individuals admitted with level 2 or 3 hypoglycaemia.
Methods: This retrospective study was conducted from October 2023 to January 2024 across 5 UK hospitals, including all adults (>18 years) admitted with level 2 or 3 hypoglycaemia from November 2022 to October 2023. Data on sociodemographics, precipitating factors, management and outcomes were collected. The Charlson comorbidity index (CCI) and clinical frailty score (CFS) were calculated to determine the 10-year survival prognosis and frailty, respectively.
Results: The study included 541 severe hypoglycaemic episodes; 237 in type 1 diabetes and 304 in type 2 diabetes. 441 episodes were level 2, and 100 were level 3. Glucagon was administered in 43 episodes. Median age, CCI, and CFS were 75.0 years, 6, and 6, respectively. Fasting/missed meals (48.8%) and intercurrent illness (14.4%) were common triggers. Hypoglycaemia was unclear in 22.2% of episodes. Cognitive impairment occurred in 24.1%, with 1.48% associated with death during hospitalisation. Insulin dose was reduced in 217 episodes and stopped in 32. Specialist referral post-discharge occurred in 146 episodes, with 20 initiating continuous glucose monitoring. Glucagon prescription at discharge was rare (5/541).
Conclusion: Individuals hospitalised for severe hypoglycaemia were typically elderly and frail, often due to missed meals or intercurrent illness. Despite risks of cognitive impairment and death, services to prevent future episodes were under-utilised. This highlights the need for targeted educational interventions to mitigate such occurrences and improve patient outcomes.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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