Incidence and Determinants of Reported Hypoglycaemia among Patients with Type 2 Diabetes Mellitus in a Tertiary Health Institution in Nigeria

Abstract

Introduction: Hypoglycaemia is a frequent and serious adverse effect of anti-diabetic therapy associated with both immediate and delayed adverse clinical outcomes. However, it continues to be a neglected complication with limited study of its burden, knowledge, determinants and preventive measures adopted by type 2 diabetics. Methods: Patients with type 2 diabetes who presented at Diabetes Clinic of a University teaching hospital and fulfilled selection criteria were recruited. The information obtained included sociodemographic, clinical details with hypoglycaemic symptoms and laboratory measurements. Results: There were 113 participants with a mean age of 60.94 ± 11.95 years. The majority of the patients had fair knowledge of hypoglycaemic symptoms and also knew what actions to take to ameliorate the symptoms when it occurs. The incidence of hypoglycaemia was 45.1% and most commonly occurred in the afternoon before lunch. The commonest symptoms reported by patients were shivering (76.1%), hunger (71.7%) sweatiness (71.5%) and weakness (69.9%). Almost one-fifth (19.6%) of those who reported hypoglycaemia had severe symptoms, of which 16.1% had hospital admission for its management. Use of insulin, duration of diabetes, age and possession of glucometers were some of the determinants of hypoglycaemic symptoms. Conclusions: The burden of reported hypoglycaemia among type 2 diabetics is significant. Hence, diabetics at risk should always be asked about symptoms at each clinic visit. Early recognition of hypoglycaemia risks, self-monitoring of blood glucose (SMBG), appropriate education programs for both health care providers and patients with diabetes are the major ways to minimize risks of hypoglycaemia.