(26-09-12) Hypoglycaemia is associated with increased length of stay and mortality in people with diabetes who are hospitalized.

Nirantharakumar K, Marshall T, Kennedy A, Narendran P, Hemming K, Coleman JJ.

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 1.1.35-1.68) 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. ? 2012
The Authors. Diabetic Medicine ? 2012 Diabetes UK.


Source: Diabet Med. 2012 Aug 31. doi: 10.1111/dme.1

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