Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Oct 15, 2016; 7(18): 470-480
Published online Oct 15, 2016. doi: 10.4239/wjd.v7.i18.470
Predictors of hypoglycemia in insulin-treated patients with type 2 diabetes mellitus in Basrah
Dhuha Tarik Nassar, Omran S Habib, Abbas Ali Mansour
Dhuha Tarik Nassar, Basrah Health Directorate, Basrah 61013, Iraq
Omran S Habib, Department of Epidemiology, Basrah College of Medicine, Basrah 61013, Iraq
Abbas Ali Mansour, Al-Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Chair Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine, Basrah 61013, Iraq
Author contributions: All authors contributed equally to the manuscript.
Institutional review board statement: Ethical committee of Basrah College of Medicine approved the study.
Informed consent statement: Informed verbal consent was taken from all patients.
Conflict-of-interest statement: None.
Data sharing statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Abbas Ali Mansour, Professor of Medicine, Consultant Endocrinologist, Al-Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Chair Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine, Hattin Post Office, P.O Box: 142, Basrah 61013, Iraq. aambaam@gmail.com
Telephone: +964-780-1403706
Received: March 12, 2016
Peer-review started: March 16, 2016
First decision: May 17, 2016
Revised: July 20, 2016
Accepted: August 17, 2016
Article in press: August 18, 2016
Published online: October 15, 2016
Processing time: 212 Days and 16.2 Hours
Abstract
AIM

To measure the incidence and determinants (predictors) of hypoglycemia among patients with type 2 diabetes mellitus (T2DM) who were on insulin treatment for at least one year.

METHODS

The present study is an out-patients based inquiry about the risk and predictors of hypoglycemia among patients with T2DM seeking care at the Al-Faiha Specialized Diabetes, Endocrine, and Metabolism Center, in Basrah over a period of 7 mo (from 15th of April, 2013 to 15th of October, 2013). The data used in the study were based on all detailed interview and selected laboratory investigations. A total of 336 patients could be included in the study.

RESULTS

The incidence of overall hypoglycemia among the studied patients was 75.3% within the last 3 mo preceding the interview. The incidence of hypoglycemia subtypes were 10.2% for severe hypoglycemia requiring medical assistance in the hospital, 44.36% for severe hypoglycemia treated at home by family; this includes both confirmed severe hypoglycemia with an incidence rate of 14.6% and unconfirmed severe hypoglycemia for which incidence rate was 29.76%. Regarding mild self-treated hypoglycemia, the incidence of confirmed mild hypoglycemia was 21.42%, for unconfirmed mild hypoglycemia the incidence rate was 50.0% and for total mild hypoglycemia, the incidence rate was 71.42%. The most important predictors of hypoglycemia were a peripheral residence, increasing knowledge of hypoglycemia symptoms, in availability and increasing frequency of self-monitoring blood glucose, the presence of peripheral neuropathy, higher diastolic blood pressure, and lower Hemoglobin A1c.

CONCLUSION

Hypoglycemia is very common among insulin-treated patients with T2DM in Basrah. It was possible to identify some important predictors of hypoglycemia.

Keywords: Diabetes mellitus; Insulin; Hypoglycemia; Out-patient; Type 2

Core tip: Outpatients study aimed to assess the frequency of hypoglycemia and their predictors among patients with type 2 diabetes mellitus on insulin for at least one year. The majority of patients (75.3%) had hypoglycemia in the preceding 3 mo. We identify some important predictors of hypoglycemia.