Prevalence and risk factors of hypoglycemia in diabetes mellitus patients having follow up at diabetic clinic at St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Abstract

Abstract Background: Hypoglycemia is most commonly caused by drugs used to treat diabetes mellitus or by exposure to other drugs, including alcohol. Hypoglycemia is most convincingly documented by: 1) symptoms consistent with hypoglycemia, 2) a low plasma glucose concentration measured with a precise method (not a glucose monitor), and 3) relief of those symptoms after the plasma glucose level is raised. Previously the prevalence and associated risk factors of hypoglycemia in diabetic patients were not studied at SPHMMC. Objective: To assess the prevalence and associated risk factors of hypoglycemia at St. Paul’s hospital diabetic clinic. Methods: Across sectional study by using structured questionnaires during patient’s visit at SPHMMC diabetic follow up clinic. Using simple random sampling 342 diabetic Patients who fulfill the inclusion criteria were studied. Data was collected by trained nurses and the principal investigator. Data was first checked manually for completeness and then analyzed using SPSS version 25.0 software and the results are presented by tables, bar graphs and pie chart. Binary logistic regression and chi square test was employed to assess the factors associated with hypoglycemia. P-values of less than 0.05 and 95% confidence intervals (CI) were used as cutoff points to determine the statistical significance of associations among different variables. Results: The study involved 342 diabetic patients (70 Type1and 272 Type2diabetics). From this hypoglycemic symptoms were reported by 101(29.5%) of the patients. Hypoglycemia was reported by 47.1% Type1and 25.0% of Type2 diabetic patients. Severe hypoglycemia was reported by 19 (18.8%) of the patients. Treatment with NPH insulin and BMI (under weight and obese) were risk factors for reported incidents of hypoglycemia symptoms [p<0.001; AOR =11.533; 95% CI (3.605-36.901)] and [p=0.016 and 0.040; AOR=0.142 and 0.380; 95%CI (0.029-0.694 and 0.151-0.957)] respectively. Conclusion: Hypoglycemia symptoms were experienced by 29.5% of diabetic patients involved in this study. Treatment with NPH insulin and BMI (under weight and obese) were risk factors for hypoglycemia symptoms. Further studies could use the results of this study to explore specific interventions targeted at these factors. Key words: Diabetes mellitus; Hypoglycemia; Risk factors