Evaluation of Insulin and Sulfonylurea Types on Severe Hypoglycemia Event Among Ambulatory Type 2 Diabetes Mellitus Patients. A Case-Control Hospital-Based Study in Bali

Background: The management of blood glucose levels in patients with type 2 diabetes mellitus (T2DM) often involves the use of effective diabetes medications, such as insulin and sulfonylurea (SU). Despite the potential, these drugs can potentially lead to hypoglycemia during treatment. Objective: Therefore, this study aims to determine the types of insulin and sulfonylureas that commonly cause hypoglycemia. Methods: Using a case-control study design, hospitalized occurrences of hypoglycemia were assessed while considering factors that influenced its incidence through Odds Ratio (OR) calculations at a confidence interval (CI) level of 95%. Results: The results showed that hypoglycemia occurred more often in patients who used insulin, SU, or both compared to non-users (p<0.05). In addition, a risk of 4.5 (CI95%: 1.580-12.817) times higher was found in patients taking insulin and SU compared to others. Conclusion: Ambulatory T2DM patients who use insulin or SU as DM therapy must be given special attention. Education related to the risk of hypoglycemia, how to use medication, and first aid in emergency conditions must be provided by health workers to outpatients with DM.