Frequency and Predictors of Hypoglycemia in Type 2 Diabetes

Background: Hypoglycemia presents a barrier to optimum diabetes management; however, data are limited on the frequency of hypoglycemia incidents outside of clinical trials. Aim: The aim of the present study was to investigate the frequency of self-reported hypoglycemic events in patients with Type 2 diabetes mellitus (T2DM) and to define factors that predict a higher risk of hypoglycemia. Materials and Methods: A sample of 1500 patients with T2DM were recruited in this prospective, observational study, selected at random from a validated community population, attending the outpatient clinic of diabetes, Ain Shams University Specialized Hospital. Eligible patients were followed up for 12 months and were instructed on the use of a diary to record hypoglycemic events. Ordinal logistic regression was performed to identify potential predictors of hypoglycemia. Results: Of a total of 1347 patients with data available for the present analysis, 583(43.28%) had experienced hypoglycemia. The participants experienced a total of 3816 hypoglycemic events during the study period, which amounts to 2.83 events (95% CI 2.74, 2.92) per patient per year. Of those who experienced hypoglycemia, 13(2.23%) recorded severe events and 125(21.44%) had evidence of impaired awareness of hypoglycemia. Patients who had experienced hypoglycemic events were elder and have higher body mass index, longer duration of diabetes, and higher HbA1c than those who had not experienced hypoglycemia, the difference was significant (all P < 0.05). Also, they were on insulin therapy, have diabetes complications, used to have irregular meals, and do not practicing exercise when compared with patients who had not experienced hypoglycemia (all P < 0.05). No significant difference was found based on gender ( P = 0.25) between patients who experienced and those had not experienced hypoglycemia. Conclusions: Hypoglycemia is a frequent adverse effect in patients with T2DM, and particular attention is warranted in elder, obese patients with poor control and longer duration of diabetes. The presence of diabetes complications, insulin therapy, and unhealthy life style are also predictors of hypoglycemia.