KMID : 1200020120360040280
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Diabetes & Metabolism Journal 2012 Volume.36 No. 4 p.280 ~ p.284
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Severe Hypoglycemia Is a Serious Complication and Becoming an Economic Burden in Diabetes
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Ha Won-Chul
Oh Su-Jin Kim Ji-Hyun Lee Jung-Min Chang Sang-Ah
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Abstract
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Background: The prevalence of hypoglycemia is increasing due to the growing incidence of diabetes and the latest strict guidelines for glycated hemoglobin (HbA1c) levels under 7%. This study examined the clinical characteristics, causal factors, and medical costs of severely hypoglycemic patients in an emergency room (ER) of Uijeongbu St. Mary¡¯s Hospital.
Methods: The study consisted of a retrospective analysis of the characteristics, risk factors, and medical costs of 320 severely hypoglycemic patients with diabetes who presented to an ER of Uijeongbu St. Mary¡¯s Hospital from January 1, 2006 to December 31, 2009.
Results: Most hypoglycemic patients (87.5%, 280/320) were over 60 years old with a mean age of 69.5¡¾10.9 years and a mean HbA1c level of 6.95¡¾1.46%. Mean serum glucose as noted in the ER was 37.9¡¾34.5 mg/dL. Renal function was decreased, serum creatinine was 2.0¡¾2.1 mg/dL and estimated glomerular filtration rate (eGFR) was 48.0¡¾33.6 mL/min/1.73 m2. In addition, hypoglycemic patients typically were taking sulfonylureas or insulin and a variety of other medications, and had a long history of diabetes.
Conclusion: Severe hypoglycemia is frequent in older diabetic patients, subjects with low HbA1c levels, and nephropathic patients. Therefore, personalized attention is warranted, especially in long-term diabetics with multiple comorbidities who may not have been properly educated or may need re-education for hypoglycemia.
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KEYWORD
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Cost, Diabetes mellitus, Health, Hypoglycemia
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