Abstract

Background: Severe hypoglycemia in

patients with diabetes is associated with increased risk of adverse cardiovascular events and death. Acute hypoglycemia is a pro-arrhythmic, pro-inflammatory and prothrombotic state and several mechanisms have been proposed to explain how hypoglycemia might increase cardiovascular morbidity and mortality. Subjects and Methods: We perform cross-sectional study on 118 patients with hypoglycemia in diabetes mellitus at Tien Giang Center General Hospital. Results: Hypoglycemia was higher in females than in males (63.56% compared to 36.44%). Mean±standard deviation age was 72.46±10.92, the prevalence of CKD stages 3 to 5 was 49.15%, 25.42% of patients reported≥1 hypoglycemic events, arrhythmia was 28.81% (included left and right bundle branche block 7.65%; Ventricular extrasystoles was 7.65%; atrial fibrillation was 6.78%; atrial extraasystoles was 5.93%; sinus bradycardia was 0.85%). Mean QTc was 443.78±78.0 ms. Prolonged QTc≥440ms was 50.86%. Myocardial ischemia was 77.12%. Patients receiving insulin therapy had 51.69% (85.24% from premix insulin). Some risk factors causing hypoglycemia were little foods intake or excessive abstinence (61.02%), change in therapeutic dose (18.64%), little foods intake and acute infections 911.02%). Hypoglycemia was associated with sex (p=0.05), duration of diabetes (p = 0.01), acute infections (p=0.03), chronic kidney disease (p=0.01),HGB (p=0.007) and associated with loss of consciousness (p=0.0001). Conclusions: Hypoglycemia may increase the vascular events. Glycemic control should be individualized. Recognition of hypoglycemia risk factors, blood glucose monitoring, selection of appropriate regimens and educational programs for healthcare professionals and patients with diabetes are the major issues to maintain good glycemic control, minimize the risk of hypoglycemia, and prevent long- term complications.