Retrospective study: Management of the initial hypoglycaemic event in hospitalised patients and its impact. (#232)
Objectives: To review the inpatient management of hypoglycaemia and its impact.
Design: Retrospective single centre study.
Patients: We analysed all documented hypoglycaemic (BSL < 3.5mmol/L) events in an acute inpatient setting between November 2011 and January 2012 at a major teaching hospital. We retrospectively reviewed the management of each episode.
Main Outcome Measures: Evaluated any association with length of stay, recurrence, preventative action taken, type of Diabetes, hypoglycaemic agent used and impact if occurred after hours.
Results: Total of 100 patients were evaluated. Of them, 57 had 1 or more recurrences, 19 were notified to the doctor after the initial episode, 42 had preventative action taken, such as modifying the dose of hypoglycaemic agent that led to the event, 47 were given complex carbohydrates after initial treatment and 62 had their initial event after-hours. If a doctor was notified of the initial hypoglycaemic event, the odds of recurrence was 30% greater (p=0.031). When a doctor was notified, preventative action was taken in 73.7% compared to 8.6% if not (p=0.002), but taking preventative action alone was not associated with the number of recurrences. Patients with recurrent episodes of hypoglycaemia were also associated with longer length of stay, 13.5 days vs. 7.5 days (p=0.001). Recurrences were not associated with age, being on insulin, type of Diabetes and the time of occurrence.
Conclusions: Hypoglycaemia is common in inpatients and not often reported to the treating doctors. This leads to recurrent episodes and is associated with a longer length of stay in hospital.