Hypoglycemia symptoms are reduced in hospitalized patients with diabetes

Aims: Hospitalized patients with diabetes are have an impaired ability to detect hypoglycemia events. The purpose of this study was to compare hypoglycemia symptom scores (HSS) in hospitalized patients with diabetes after a documented blood glucose (BG) <70 mg/dl with recalled HSS with outpatient hypoglycemia events. Methods: Non-critically ill hospitalized patients with diabetes grouped as symptomatic (n = 23) or asymptomatic (n = 32) at time of index hypoglycemia completed a standardized HSS-Questionnaires (HSS-Q) related to the inpatient event and to recall of symptoms with outpatient hypoglycemia. Results: After controlling for BG at time of index hypoglycemia (49.8 +/- 11.4 vs. 57.4 +/- 6.8 mg/dl, p = 0.02), symptomatic patients reported higher HSS than asymptomatic patients with the inpatient event (11.6 +/- 7.3 vs. 1.5 +/- 3.4, p < 0.001) and in the outpatient setting (13.9 +/- 8.6 vs. 10.1 +/- 10.6, p < 0.01). Recurrent hypoglycemia was more frequent in asymptomatic patients (13% vs. 44%, p = 0.015) during the hospitalization. Conclusions: Compared to symptomatic patients, asymptomatic patients had lower inpatient and outpatient HSS and more frequent recurrent hypoglycemia events. These results suggest modification of glycemic management strategies in high risk patients to reduce risk for hypoglycemia events.

Automated summary

Hospitalized patients with diabetes, especially those who are asymptomatic, have impaired ability to detect hypoglycemia events. Modification of glycemic management strategies may be needed to reduce the risk for hypoglycemia in high-risk patients.