Trends of the Patients Hospitalized for Severe Hypoglycemia in Type 2 Diabetes

Aim : Severe hypoglycemia remains a major complication of diabetes ; however, the background of patients with severe hypoglycemia requiring hospitalization has not been unraveled. Therefore, in this study, we examined the characteristics of patients who required hospitalization for severe hypoglycemia. Methods : We included 330 patients with severe hypoglycemia who had type 2 diabetes and who visited the Aizawa Hospital Emergency and Critical Care Center during a 12-year period. Furthermore, we divided the patients into two groups : patients treated with insulin (INS-group) and those treated with oral hypoglycemic agents without insulin (OHA-group). We examined the time of hospital visits and the proportion of patients requiring hospitalization. Results : The proportion of patients requiring hospitalization was significantly lower in the INS-group than in the OHA-group. The proportion of patients who visited the hospital because of severe hypoglycemia between 12 : 00 and 17 : 59 was significantly higher in the INS-group than in the OHA-group. There was no significant difference in the proportion of patients who were hospitalized and those who could return home across all periods in the INS-group. The proportion of hospitalized patients was low between 0 : 00 and 5 : 59 and high between 18 : 00 and 23 : 59 in the OHA-group. Conclusions : In insulin-treated patients, there is a risk of severe hypoglycemia, even with poor glycemic control. However, patients treated with OHA alone were at increased risk of hospitalization for severe hypoglycemia in cases of excessively good control and the visit time between 18 : 00 and 23 : 59.These findings suggest strategies that can reduce the risk of severe hypoglycemia and hospitalization.