Characteristics and mortality of type 2 diabetic patients hospitalized for severe iatrogenic hypoglycemia.

Aims: Severe hypoglycemia can be dramatic in diabetic patients, but its long-term outcome is unknown. We aimed to describe clinical characteristics of type 2 diabetic patients hospitalized for iatrogenic hypoglycemia, and find predictors of long-term mortality, with a special regard to anti-hyperglycemic regimens.

Methods: We retrospectively analyzed 126 episodes of severe hypoglycemia in type 2 diabetic patients. We collected data on the event (coma, pre-hospital fall, glucose level, duration of hypoglycemia), concomitant risk factors, diabetic complications and chronic comorbidities. We divided patients according to the use of insulin or oral agents (OHAs). In-hospital outcomes were acute coronary syndrome (ACS) and duration of hospitalization. We finally assessed long-term mortality.

Results: Hypoglycemia due to OHA was associated with higher prevalence of coma and longer duration than hypoglycemia due to insulin. OHA use was also associated with a longer hospital stay, but no increase in the incidence of ACS. Overall mortality after a 2-year median follow-up was 42.1%. Despite the apparent worse presentation of hypoglycemic episodes associated with OHA use, this did not lead to an increased long-term mortality.

Conclusions: Severe iatrogenic hypoglycemia in OHA-treated patients has a worse presentation, but is not associated with a higher long-term mortality than in insulin-treated patients.