Hypoglycaemia among patients with type II diabetes mellitus: A retrospective study

Abstract

INTRODUCTION AND OBJECTIVES; Although there is emphasis on strict glucose control in type II diabetes mellitus (T2DM), information about problems that occur due to hypoglycaemia, especially in resource-poor settings, is lacking. We aimed to determine the prevalence of symptomatic hypoglycaemia, awareness of hypoglycaemia and knowledge about avoiding, detecting and treating hypoglycaemia, in a cohort of patients with T2DM. Methods: A descriptive, retrospective study of patients with T2DM attending general medical clinics of the University Medical Unit, Teaching Hospital, Ragama was carried out for 7 months from May 2012 using an interviewer administered questionnaire. RESULTS: Three hundred patients were recruited. One hundred and two (34%) had experienced at least one hypoglycaemic episode, and more than 2 episodes were experienced by 88 (86.3%). Commonest symptoms were sweating (65.7%) and palpitations (54%). Neuroglycopaenic symptoms were experienced by 54 (52.9%) and 18 (17.6%) had "become unconscious. Thirty (29.4%) had required hospital admission. Sixty nine (67.6%) were on sulphonylurea alone or in combination with metfonnin. Sixty nine (67.6%) were unaware of hypoglycaemia. Main reasons for hypoglycaemia were missed meals 49 (48%) and associated illness 49 (23.5%). Two hundred and thirty eight (79.3%) knew how to treat hypoglycaemia and 151 (50.3%) had received information on hypoglycaemia from medical officers. Two hundred and sixty one (87%) were not using a glucometer and 223 (74%) were unaware of such a device, although 249 (83%) said they could afford one. CONCLUSIONS: Hypoglycaemia is a common but under-recognised symptom among T2DM patients. Severe or recurrent hypoglycaemia is associated with a high cost to the individual and to the health service. Raising awareness by health education, with emphasis on self-monitoring where possible, should receive priority.