Low Blood Glucose Levels in Hospitalized Patients Linked to Increased Mortality Risk

In hospitalized patients, hypoglycemia is associated with increased mortality risk, according to a study recently published in The Journal of Clinical Endocrinology & Metabolism.

The paper comes as a coalition of diabetes stakeholders issues a strategic and actionable blueprint to address the deadly threat hypoglycemia poses to people with diabetes. (See the special section on the Endocrine Society’s blueprint for managing and preventing the complication in our November issue.)

Researchers led by Amit Akirov, MD, of Rabin Medical Center in Petah Tikva, Israel, point out that in-hospital insulin treatment is associated with an increased risk of hypoglycemia, which is often asymptomatic due to “hypoglycemia unawareness or altered consciousness associated with acute illness or drug therapy.” So in-hospital insulin treatment leads to complications with hypoglycemia, which in turn leads to other complications such as ischemic events and longer hospital stays.

The researchers analyzed data from nearly 3,000 patients with hypoglycemia at a 1,330-bed university-affiliated medical center. They evaluated medical records and the hospital’s mortality database to investigate the association between hypoglycemia and mortality in hospitalized patients. They found that for patients with hypoglycemia, almost 32% had died at the end of the follow-up period.

Mortality risk was higher in insulin-treated patients with moderate hypoglycemia (40-70 mg/dL), compared to patients without insulin treatment with similar glucose values. However, with severe hypoglycemia (<40 mg/dl), the increase in mortality risk was similar with insulin-related and non-insulin related hypoglycemia.  Cause of admission did not affect the association between glucose levels and mortality. “Hypoglycemia is common among hospitalized patients with and without diabetes mellitus,” says Akirov. “Our findings suggest that hypoglycemia, whether insulin-related or non-insulin related, is associated with short- and long-term mortality risk. These data are a timely reminder that hypoglycemia of any cause carries the association with increased mortality.”

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