Objective: This research aimed to assess the prevalence, presentation, and risk factors associated with hypoglycemia in non-critically ill vs. critically ill inpatients at a tertiary care hospital in North India, focusing on identifying differences in clinical parameters and outcomes between these two patient populations over six months.
Methodology: This six-month prospective study, conducted at a tertiary care hospital in North India, evaluated the frequency, presentation, and prevention of hypoglycemia in 200 hospitalized patients, evenly divided between non-critically ill and critically ill groups. Data collection involved recording baseline parameters and daily blood glucose levels and documenting hypoglycemic episodes and their severity. Preventive strategies, including glucose monitoring, medication adjustments, and dietary interventions, were also tracked. The study used chi-square and t test analysis to determine the prevalence of hypoglycemia, recurrent episodes, and the effectiveness of preventive measures, focusing on differences between the two patient groups and the impact of management strategies.
Results: The study found that critically ill patients were older (65 ± 15 years) than non-critically ill patients (60 ± 12 years, p = 0.036) with a similar proportion of females in both groups (50% vs. 45%, p = 0.527). Hypoglycemia was more common in critically ill patients (45% vs. 25%, p = 0.005), as were cardiovascular disease (50% vs. 30%, p = 0.004) and chronic kidney disease (35% vs. 20%, p = 0.023). Nutrition consultations were more frequent in non-critically ill patients (30% vs. 15%, p = 0.025), while medication adjustments were more common in critically ill patients (40% vs. 20%, p = 0.004). Non-recurrent hypoglycemia was higher in non-critically ill patients (68% vs. 44.4%, p = 0.038), whereas recurrence was higher in critically ill patients (55.6% vs. 32%, p = 0.038).
Conclusion: The study highlights the significance of addressing hypoglycemia in non-critically ill inpatients, a group that is often overlooked compared to critically ill patients. Although non-critically ill patients had fewer comorbidities and a lower incidence of previous hypoglycemia, the occurrence of hypoglycemia in this group remains a concern. The findings indicate that, even in non-critically ill patients, careful management of factors such as insulin therapy and underlying conditions like type 2 diabetes is essential to prevent hypoglycemic episodes. These results emphasize the need for targeted interventions in non-critical care settings to mitigate the risk of hypoglycemia and enhance patient safety and outcomes.
Keywords: glycemic control; hyperglycemia; hypoglycemia; undiagnosed; unnoticed medication.
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