Aging and comorbidities influence the risk of hospitalization and mortality in diabetic patients experiencing severe hypoglycemia |
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| Affiliation: | 1. Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy;2. Emergency Medicine Department, AOU Maggiore della Carità, Novara, Italy;3. Division of General Medicine, Ospedale S. Giuseppe, I.R.C.C.S. Istituto Auxologico Italiano, Verbania, Italy;1. Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, USA;2. Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA;1. Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran;2. Imaging Department, Taleghani Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran;3. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran;4. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran;1. Laboratory of Exercise Physiology, Faculty of Physical Education, University of Campinas, Campinas, São Paulo, Brazil;2. Department of Physical Education, State University of Maringa, Maringa, Brazil;3. Department of Physical Education, University of Parana, Curitiba, Brazil;4. Federal Institute of Education, Science and Technology of São Paulo, Hortolandia Campus, Hortolandia, Brazil;1. Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India;2. Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006, India;3. Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006, India;1. Unit of Cardiovascular Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy;2. Unit of Food Science and Nutrition, Department of Science and Technology for Humans and the Environment, Campus Bio-Medico University of Rome, Rome, Italy |
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| Abstract: | Background and aimsTo assess the risk of hospitalization and mortality within 1 year of severe hypoglycaemia and theirs clinical predictors.Methods and resultsWe retrospectively examined 399 admissions for severe hypoglycemia in adults with DM at the Emergency Department (ED) of the University Hospital of Novara (Italy) between 2012–2017, and we compared the clinical differences between older (aged ≥65 years) and younger individuals (aged 18–64 years). A logistic regression model was used to explore predictors of hospitalization following ED access and 1-year later, according to cardiovascular (CV) or not (no-CV) reasons; 1-year all-cause mortality was also detected.The study cohort comprised 302 patients (median [IQR] age 75 [17] years, 50.3% females, 93.4% white, HbA1c level 7.6% [1.0%]). Hospitalization following ED access occurred in 16.2% of patients and kidney failure (OR 0.50 [95% CI 1.29–5.03]) was the only predictor of no-CV specific hospitalization; 1-year hospitalization occurred in 24.5% of patients and obesity (OR 3.17 [95% CI 1.20–8.12]) and pre-existing heart disease (OR 3.20 [95% 1.20–9.39]) were associated with CV specific hospitalization; 1-year all-cause mortality occurred in 14.9% of patients and was associated with older age (OR 1.12 [95% CI 1.07–1.18]) and pre-existing heart disease (OR 2.63 [95% CI 1.19–6.14])ConclusionsSevere hypoglycemia is associated with risk of hospitalization and mortality mainly in elderly patients and it may be predictive of future cardiovascular events in diabetic patients with pre-existing heart disease and obesity. |
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| Keywords: | Diabetes mellitus Hypoglycaemia Hospitalization Mortality Cardiovascular risk |
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