Hypoglycemia in Hospitalized Patients with or without Heart Failure.
Diabetes Obes Metab. 2018 May 24;:
Authors: Merrill J, Dungan K
Hospitalized patients with heart failure (HF) undergoing bedside glucose monitoring with subcutaneous insulin orders were retrospectively identified over two years. Hypoglycemia was defined as any glucose < 3.9 mmol/L (70 mg/dl) within 24 hours of admission (Hypo1day ) or throughout the hospitalization (HypoT ) or any glucose < 2.2 mmol/L (40 mg/dl) throughout the hospitalization (HypoSevere ). 13,424 patients were included; 2,484 with HF. HF patients were more likely to have Hypo1day (9.1 vs. 7.0%, p=0.0003), HypoT (28 vs. 18.5%, p<0.0001), or Hypo Severe (3.4 vs. 2.1%, p=0.0001). After controlling for other variables, the odds of Hypo1day were similar between HF and non-HF patients (OR 1.14, 95% CI 0.94-1.39, p=0.18, fully adjusted model), slightly lower for HypoT (OR 0.85, 95% CI 0.73-0.99, p=0.03, fully adjusted model), and similar for HypoSevere (OR 1.25, 95% CI 0.91-1.70, p=0.17). Hypo1day , HypoT , and HypoSevere were all associated with increased mortality; there was no evidence of an interaction by HF status. Hypoglycemia occurs at a similar or lower frequency in hospitalized patients with HF compared to those without HF. Hypoglycemia is associated with increased hospital mortality, regardless of HF status. This article is protected by copyright. All rights reserved.
PMID: 29797767 [PubMed - as supplied by publisher]