Impact of hypoglycemia in hospitalized patients

Michelle Carey, Laura Boucai, Joel Zonszein

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Hypoglycemia is a common problem in hospitalized patients, particularly the elderly, frail, and severely ill. Hypoglycemia has been implicated in the development of adverse clinical outcomes, including increased mortality. Fear of iatrogenic hypoglycemia remains an obstacle to adequate inpatient glycemic control. However, evidence from large clinical trials is mixed: several intensive care unit studies have shown either reduced or no change in mortality with intensive glycemic control, despite high rates of iatrogenic hypoglycemia, and only 1 large study showed higher mortality. In the general ward setting, the association of hypoglycemia with worse outcomes and mortality has been frequently reported, but after multivariate adjustment for comorbidities this association disappears. Spontaneous hypoglycemia, rather than iatrogenic hypoglycemia, is strongly associated with mortality suggesting that hypoglycemia behaves as a biomarker rather than a causative factor of adverse outcomes. Inpatient glycemic management should be patient-centered, follow the current guidelines, and aimed at preventing hypoglycemia.

Original languageEnglish (US)
Pages (from-to)107-113
Number of pages7
JournalCurrent Diabetes Reports
Volume13
Issue number1
DOIs
StatePublished - Feb 1 2013

Keywords

  • Diabetes
  • Hospital
  • Hypoglycemia
  • Inpatient
  • Mortality

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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