Hypoglycemia increased mortality, length of hospital stay in patients with diabetes

Patients with diabetes who develop hypoglycemia while hospitalized for non-critical illnesses face a greater risk for mortality and longer length of hospital stay both during and after hospitalization.

Due to the increased risks from hypoglycemia, measures should be taken to decrease the frequency of hypoglycemia in this high-risk population, according to researchers at Brigham and Women’s Hospital.

“We need to do more to prevent hypoglycemia in the hospital by carefully monitoring the patients’ condition and appropriately adjusting their anti-hyperglycemic regimen,” Alexander Turchin, MD, of the division of Endocrinology, Diabetes and Hypertension, told Endocrine Today.

The researchers examined whether hypoglycemic episodes are associated with higher mortality in 2,582 patients with diabetes hospitalized in the general ward. Researchers evaluated associations between the number and severity of hypoglycemic (≤50 mg/dl) episodes and length of stay, inpatient mortality and mortality within one year after discharge.

Hypoglycemia was observed in about 8% of the study population. An increase of 85.3% in the odds for inpatient death (P=.009) and 65.8% (P=.0003) in the odds for death occurred within one year from discharge.

In addition, there was a three-fold increased risk in the odds for inpatient death for every 10 mg/dL decrease in the lowest blood glucose during hospitalization (P=.0058). For each day with hypoglycemia, length of stay increased by 2.5 days (P<.0001).

The researchers suggest monitoring patients with diabetes admitted to the general ward for hypoglycemia and to interpret it as “a warning sign of impending clinical deterioration.” – by Jennifer Southall

Turchin A. Diabetes Care. 2009; 32:1153-1157.