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Risk Factors for Hypoglycemia During Treatment of Hyperglycemic Crises
Robert C Ross1, Nichelle S Vadakkel2, Kearsten Westmoreland3
1North Florida/South Georgia Veterans Health System.
Diabetes Spectrum : a Publication of the American Diabetes Association
|December 23, 2022
Summary
Hypoglycemia risk factors during hyperglycemic crisis treatment include being underweight, having type 1 diabetes, or chronic kidney disease. Specific insulin types and resuming prior regimens also increase risk.
Area of Science:
- Endocrinology
- Critical Care Medicine
Background:
- Diabetic ketoacidosis and hyperosmolar hyperglycemic state are severe hyperglycemic crises.
- Treatment involves intravenous and subcutaneous insulin, but hypoglycemia is a common complication.
- Risk factors for hypoglycemia during treatment are not well-established.
Purpose of the Study:
- To assess risk factors associated with hypoglycemia during treatment for hyperglycemic crises in ICU patients.
Main Methods:
- A case-control study of 216 ICU patients with hyperglycemic crises.
- Compared patients who developed hypoglycemia with a control group.
- Assessed odds of hypoglycemia based on BMI, comorbidities, and subcutaneous insulin type.
Main Results:
- Hypoglycemia occurred in 61 cases.
- Increased odds of hypoglycemia observed in underweight patients, those with type 1 diabetes, and chronic kidney disease.
- Resuming chronic subcutaneous insulin regimens and using NPH versus glargine insulin were associated with higher hypoglycemia odds.
Conclusions:
- Several factors are linked to hypoglycemia during hyperglycemic crisis treatment.
- Findings may aid clinicians in preventing complications and guide future research.
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