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Self reported hypoglycemia in patients with type 2 diabetes mellitus taking oral anti-diabetics

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International Journal of Diabetes in Develo** Countries Aims and scope Submit manuscript

Abstract

Objective

To determine the proportion of patients of type 2 Diabetes taking oral antidiabetics with self reported hypoglycemia and its causes.

Background

Hypoglycemia, an acute complication of diabetes mellitus is not only responsible for recurrent morbidity but also can lead to permanent brain damage or fatality if not recognized and treated in time. Also, hypoglycemia prevents achieving glycemic targets in diabetic patients.

Methods

Cross-sectional observation study of 70 patients of type 2 diabetes on oral anti-diabetics was conducted at Lok Nayak Hospital to determine the proportion of patients with self reported hypoglycemia and also to find out the various causes of hypoglycemia by subjecting them to a structured questionnaire. Hypoglycemia was considered when patient experienced at least one symptom, at least 2–3 times in last one month and symptom(s) were relieved by consuming sugar/meal.

Results

38.6% of the study subjects had hypoglycemia, out of which 92.59% patients had symptomatic hypoglycemia. Out of the patients experiencing hypoglycemia, 32% had severe episodes, 12% visited the hospital and 48% had more than 5 episodes per month. Dizziness was the commonest reported symptom (64%), followed by palpitations (52%). Attributed causes of hypoglycemia were missing meal (64%), drugs other than oral anti-diabetics (44%), sulfonylureas (44.2% in patients taking vs. 26.9% in patients not taking sulfonylurea), comorbidities (41% with vs. 22.4% without comorbidities) and lower socioeconomic status. One-third of patients experiencing were checking blood glucose levels during the symptoms. Highest prevalence of hypoglycemia was seen with HbA1c < 6.5% (p-value 0.04 when compared with subjects with HbA1c ≥ 6.5%), followed by ≥ 8% and least in 6.5–7.9%.

Conclusions

Lower prevalence of hypoglycemia in our study compared to other similar studies could be because of non-inclusion of patients on insulin in our study. High prevalence of multiple episodes justify the fact that hypoglycemia begets hypoglycemia. Hypoglycemia progressively increased as socioeconomic status changed from higher to lower, possibly due to non-availability of glucometer and lack of information. U-shaped correlation of hypoglycemic events was found with HbA1c levels.

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Authors and Affiliations

  1. Department of General Medicine, Maulana Azad Medical College and Associated Hospitals, Room No. 126, BL Taneja Block, Bahadur Shah Zafar Marg, New Delhi, 110002, India

    Mahak Golani, Sanjay Pandit & Sumeet Singla

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  1. Mahak Golani
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  2. Sanjay Pandit
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  3. Sumeet Singla
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Corresponding author

Correspondence to Sanjay Pandit.

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Ethical clearance

The study was conducted after taking approval from Institutional Ethics Committee of Maulana Azad Medical College dated 14/01/2021 vide letter no. F.1/IEC/MAMC/(82/10/2020/No.64. Each subject was given a consent form to fill. Subjects were explained the purpose of study and his/ her right to quit at any time without giving the reasons. Patient’s information was dealt with confidentiality. Any abnormality detected during the screening of subjects was appropriately managed.

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Golani, M., Pandit, S. & Singla, S. Self reported hypoglycemia in patients with type 2 diabetes mellitus taking oral anti-diabetics. Int J Diabetes Dev Ctries (2024). https://doi.org/10.1007/s13410-024-01326-4

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