Prognostic factors for hospitalization for severe hypoglycemia without diabetes mellitus: a retrospective study

Patients with non-diabetic hypoglycemia have a poorer prognosis than those with diabetic hypoglycemia. However, the factors associated with prognosis remain unclear. Therefore, this study aimed to identify the prognostic factors for non-diabetic hypoglycemia. This is a retrospective study of patients hospitalized for severe hypoglycemia with blood glucose ≤ 3.0 mmol/L (54 mg/dL) due to non-diabetic hypoglycemia between April 2008 and June 2023. Additionally, the underlying cause of hypoglycemia was identified, and the factors associated with mortality were examined. Of the 134 hospitalized patients, 126 were analyzed, excluding cases of multiple or scheduled hospitalizations. The most common causes of hypoglycemia were malnutrition (n = 79, 62.7%), alcohol intake (n = 27, 21.4%), and hypothermia (n = 27, 21.4%); 76 (60.3%) patients had multiple associated factors. Of the 126 patients, 52 died within 90 days. In the multivariate analysis, the estimated glomerular filtration rate (eGFR) (< 30 mL/min/1.73 m²) was independently associated with death [odds ratio (OR) 5.78, 95% confidence interval (CI) 1.69-19.8], whereas blood glucose (OR 0.95, 95% CI 0.92-0.99), serum albumin (OR 0.27, 95% CI 0.12-0.59), and alcohol intake (OR 0.03, 95% CI 0.004-0.34) were associated with survival. Moreover, age (OR 1.0, 95% CI 0.97-1.04) was not associated with death. Patients with non-diabetic hypoglycemia had a very high mortality. Low eGFR, blood glucose levels, and serum albumin levels at admission were associated with 90-day mortality, and alcohol intake was associated with survival.