Iatrogenic hypoglycaemia is the limiting factor in achieving optimal glucose control of Diabetes. It causes recurrent morbidity in most persons with type 1 diabetes mellitus (T1DM) and in many of those with advanced type 2 diabetes mellitus (T2DM) and it may be sometimes fatal. We audit this to see if our local incidence of hypoglycaemia in diabetic patients within Gold Coast health district services, triggering factors, complications of hypoglycaemia and appropriateness of disposal from the emergency departments are comparable to other studies.
We reviewed all patients presented to the emergency department with documented hypoglycaemia in both Robina and Gold Coast Hospital from the 1st of January 2011 to the 31st of December 2011. The notes were obtained from the medical record department from the Gold Coast hospital and EMR (electronic medical records), blood results were obtained from Auslab, Auscare and external pathology (QML& S&N), and clinical attendance rates were obtained from HBCIS. The inclusion criteria were aged 16 years and over, documented hypoglycaemia (bsl <3.9) and diabetes. Exclusion criteria were non diabetes and inadequate notes.A total of 161 episodes (103 from GCH and 58 from RH) were entered as admitted with hypoglycaemia but 113 patients (45 patients from RH and 68 patients from GCH )were reviewed after exclusion.
Patients presenting with hypoglycaemia in our district is equally distributed between T1DM and T2DM (50.5%vs49.5%). In our population, hypoglycaemia requiring hospitalization is more common in men than in women (64%vs36%).Precipitating factors are consistent with those reports including poor oral intake and polypharmacy. The consequences of hypoglycaemia are observed as loss of consciousness(22%), seizures(4%), confusion(12%), falls(3%) but no documented death. Most patients are appropriately disposed to GP(85%), Endocrinologist(57%), and etc. During the study period, number of hospital admission was increased in summer possibly due to increased population at coastal area during holiday season.( summer30%, spring26% and 22% for autumn and winter respectively).