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Hypoglycaemia is associated with increased length of stay and mortality in people with diabetes who are hospitalized.
Diabet Med. 2012 Dec; 29(12):e445-8.DM

Abstract

AIM

To study the length of stay and inpatient mortality of patients with diabetes who had an episode of hypoglycaemia in a non critical care setting at University Hospital Birmingham, UK.

METHODS

Retrospective analysis of routinely available electronic data of 6374 admissions with a recording of either laboratory or point-of-care blood glucose value. Based on the lowest recorded blood glucose values, patients were categorized into a group without hypoglycaemia (> 3.9 mmol/l), a group with mild to moderate hypoglycaemia (2.3-3.9 mmol/l) and a group with severe hypoglycaemic (≤ 2.2 mmol/l). Length of stay and inpatient mortality were compared between the three groups, adjusting for age, gender, ethnicity, deprivation, admission type, use of insulin and modified Charlson co-morbidity score.

RESULTS

There were 148 admissions (2.3%) with severe hypoglycaemia (≤ 2.2 mmol/l), 500 admissions (7.8%) with mild to moderate hypoglycaemia (2.2-3.9 mmol/l) and 5726 admissions with no recorded hypoglycaemic episode (> 3.9 mmol/l). After adjustment, length of stay, when compared with those without a recorded hypoglycaemic episode, was 1.51 (95% CI 1.35-1.68) times higher in the group with blood glucose values of 2.3-3.9 mmol/l and 2.33 (95% CI 1.91-2.84) higher in the group with blood glucose values ≤ 2.2 mmol/l. Adjusted odds ratio of inpatient mortality when compared with the group without hypoglycaemia was 1.62 (95% CI 1.16-2.27) in the group with blood glucose values of 2.3-3.9 mmol/l and 2.05 (95% CI 1.24-3.38) in the group with blood glucose values ≤ 2.2 mmol/l.

CONCLUSION

Hypoglycaemia is associated with increased length of stay and inpatient mortality. Whilst causative evidence is lacking, our data are consistent with the need to avoid hypoglycaemia in our current and continued approach for optimal glycaemic control in people with diabetes admitted to hospital.

Authors+Show Affiliations

University of Birmingham, Birmingham, UK. k.nirantharan@bham.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22937877

Citation

Nirantharakumar, K, et al. "Hypoglycaemia Is Associated With Increased Length of Stay and Mortality in People With Diabetes Who Are Hospitalized." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 29, no. 12, 2012, pp. e445-8.
Nirantharakumar K, Marshall T, Kennedy A, et al. Hypoglycaemia is associated with increased length of stay and mortality in people with diabetes who are hospitalized. Diabet Med. 2012;29(12):e445-8.
Nirantharakumar, K., Marshall, T., Kennedy, A., Narendran, P., Hemming, K., & Coleman, J. J. (2012). Hypoglycaemia is associated with increased length of stay and mortality in people with diabetes who are hospitalized. Diabetic Medicine : a Journal of the British Diabetic Association, 29(12), e445-8. https://doi.org/10.1111/dme.12002
Nirantharakumar K, et al. Hypoglycaemia Is Associated With Increased Length of Stay and Mortality in People With Diabetes Who Are Hospitalized. Diabet Med. 2012;29(12):e445-8. PubMed PMID: 22937877.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hypoglycaemia is associated with increased length of stay and mortality in people with diabetes who are hospitalized. AU - Nirantharakumar,K, AU - Marshall,T, AU - Kennedy,A, AU - Narendran,P, AU - Hemming,K, AU - Coleman,J J, PY - 2012/9/4/entrez PY - 2012/9/4/pubmed PY - 2013/5/18/medline SP - e445 EP - 8 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet. Med. VL - 29 IS - 12 N2 - AIM: To study the length of stay and inpatient mortality of patients with diabetes who had an episode of hypoglycaemia in a non critical care setting at University Hospital Birmingham, UK. METHODS: Retrospective analysis of routinely available electronic data of 6374 admissions with a recording of either laboratory or point-of-care blood glucose value. Based on the lowest recorded blood glucose values, patients were categorized into a group without hypoglycaemia (> 3.9 mmol/l), a group with mild to moderate hypoglycaemia (2.3-3.9 mmol/l) and a group with severe hypoglycaemic (≤ 2.2 mmol/l). Length of stay and inpatient mortality were compared between the three groups, adjusting for age, gender, ethnicity, deprivation, admission type, use of insulin and modified Charlson co-morbidity score. RESULTS: There were 148 admissions (2.3%) with severe hypoglycaemia (≤ 2.2 mmol/l), 500 admissions (7.8%) with mild to moderate hypoglycaemia (2.2-3.9 mmol/l) and 5726 admissions with no recorded hypoglycaemic episode (> 3.9 mmol/l). After adjustment, length of stay, when compared with those without a recorded hypoglycaemic episode, was 1.51 (95% CI 1.35-1.68) times higher in the group with blood glucose values of 2.3-3.9 mmol/l and 2.33 (95% CI 1.91-2.84) higher in the group with blood glucose values ≤ 2.2 mmol/l. Adjusted odds ratio of inpatient mortality when compared with the group without hypoglycaemia was 1.62 (95% CI 1.16-2.27) in the group with blood glucose values of 2.3-3.9 mmol/l and 2.05 (95% CI 1.24-3.38) in the group with blood glucose values ≤ 2.2 mmol/l. CONCLUSION: Hypoglycaemia is associated with increased length of stay and inpatient mortality. Whilst causative evidence is lacking, our data are consistent with the need to avoid hypoglycaemia in our current and continued approach for optimal glycaemic control in people with diabetes admitted to hospital. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/22937877/Hypoglycaemia_is_associated_with_increased_length_of_stay_and_mortality_in_people_with_diabetes_who_are_hospitalized_ L2 - https://doi.org/10.1111/dme.12002 DB - PRIME DP - Unbound Medicine ER -