QJM, Vol 91, Issue 7 505-510, Copyright © 1998 by Oxford University Press
SP Hart and BM Frier
In the community, acute hypoglycaemia is commonly caused by therapies for
diabetes mellitus or the excessive consumption of alcohol. Although most
episodes do not require admission to hospital, little information is
available on the causes and outcome of those that do. We retrospectively
surveyed adult patients admitted to a large urban teaching hospital with
acute hypoglycaemia in a 12-month period, identifying 56 admissions of 51
patients. Forty-one had diabetes mellitus, 33 (80%) of whom were receiving
treatment with insulin. The others had hypoglycaemia induced by excessive
consumption of alcohol or by deliberate self-poisoning with insulin. A
history of psychiatric illness and/or chronic alcoholism was common.
Neurological manifestations of hypoglycaemia were the principal reason for
admission, observed on 50 occasions (89%), and 11 events (20%) had
precipitated convulsions. Although many patients (59%) had received
treatment for hypoglycaemia before admission, hypoglycaemia recurred in 16%
of patients in hospital. Four patients (7%) died following admission, but
in only one case was this the direct result of hypoglycaemia. However,
within 15 months of the index hypoglycaemia event, a further six patients
(11%) had died, mostly of causes unrelated to hypoglycaemia. Patients who
require hospital admission for treatment of hypoglycaemia have a high
incidence of neurological manifestations, a high rate of mental illness and
other medical disorders, and may represent a high-risk subgroup with a poor
long-term prognosis.
ORIGINAL PAPERS
Causes, management and morbidity of acute hypoglycaemia in adults requiring hospital admission
Department of Diabetes, Royal Infirmary of Edinburgh, UK.
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