2021, Vol. 3, Issue 1, Part F

Background: Hypoglycemia is an endocrine emergency which presents with a variety of symptoms ranging from impaired cognitive function to convulsions, coma and death. This study would ascertain the causes, and also the frequency of presentation of hypoglycaemia in subjects presenting to a city accident and emergency department of a tertiary care hospital.

Methodology: A retrospective review of records of case papers of hypoglycemic cases (HGT/RBS <70mg/dl) from January 2015 to December 2015 was conducted to gather data on patient age, gender, HGT (RBS), past history of liver cirrhosis, chronic kidney disease, concomitant infection or other causes of febrile illness, concomitant malignancy, concomitant stroke, lack of recent meal. A total of 91 cases were enrolled in our study. All values were recorded from patients’ ED case papers. Patients with RBS levels less than 70mg/dl were included in the study. Elderly age was defined as an age above 65years old. Neonatal and pediatric patients (age less than 18 years old) were excluded.

Results: Hypoglycemia is related to several co-morbidities. In total, 84 of the patients had Diabetes and 44 were on OHA, 37 on Insulin or both. 2 had liver cirrhosis and 29 had underlying CKD, 23 had fever in past 48 hours 24 had missed recent meal and/or 28 had anorexia secondary to underlying illness, 12 had cerebrovascular event, 11 were concomitant with malignancy, 4 unknown etiology or data missing.

Conclusion: When Hypoglycemic patients present to Emergency department, emergency physicians should pay attention to the presence of infection, malignancy, liver diseases and renal failure. Greater emphasis on intensive glycemic control and Insulin with OHAs has resulted in increased emergency department visit rates for hypoglycemia.