Demographics of inpatients presenting with hypoglycaemia to a district general hospital

Aim: To demonstrate characteristics and glycaemic control for patients admitted to secondary care with an acute hypoglycaemic attack. Method: All patients seen by the specialist diabetes team (SDT) with admission diagnosis of hypoglycaemia from June 2007 to December 2010 were studied. Results: Of 2,002 patients seen by the SDT, 11.6% (n = 233) presented with hypoglycaemia as the primary diagnosis. The mean age was 71.98 ± 13.64 years, 56% (n = 130) were males and 94% (n = 219) had Type 2 diabetes. The mean baseline HbA1c was 58mmol/mol (7.48% ± 1.59). Follow-up HbA1c after treatment relaxation was marginally but not significantly higher at 59mmol/mol (7.59% ± 1.57, p = 0.2). 66.8% of patients in this cohort were above 70 years of age. The HbA1c increased in those aged <70 years 58mmol/mol (7.50% ± 1.75) vs 60mmol/mol (7.64% ± 1.87, p = 0.4) and for aged>70 years 58mmol/mol (7.47% ± 1.51) vs 59mmol/mol (7.56% ± 1.40, p = 0.4). Conclusion: Nearly 60% of patients in this cohort were over the age of 70 years. Tight glycaemic control in elderly patients may sometimes be detrimental. Poor nutritional status, associated comorbidities such as dementia, cerebrovascular accident, poor cognitive status, worsening renal and liver functions and polypharmacy may predispose them to increased risk of hypoglycaemia.Management should therefore be tailor-made taking the above factors into consideration as well as their ability to recognise and treat hypoglycaemia. SDTreview during their hospital stay may provide a unique opportunity to empower patients and address such issues.