Hypoglycemia-associated Mortality Is Not Drug-associated but Linked to Comorbidities
Am J Med Nov 2011
Tight glucose control is associated with increased rate of hypoglycemia. This study aimed to determine if the mortality risk associated with hypoglycemia in hospitalized noncritically ill patients is linked to glucose-lowering medications (drug-associated hypoglycemia) or merely an association mediated by comorbidities (spontaneous hypoglycemia).
Method: Retrospective cohort of 31,970 patients admitted to the general wards aimed to determine inhospital mortality (<70 mg/dL) -spontaneous and drug-associated hypoglycemia.
· A total of 10.5% of patients had ¥ episode of hypoglycemia. Patients with hypoglycemia were older, had more comorbidities, and received more antidiabetic agents.
· Hypoglycemia was associated with increased in-hospital mortality (HR, 1.67; 95% CI, 1.33-2.09; P.001).
· Mortality risk was limited to patients with spontaneous hypoglycemia (HR, 2.62; 95% CI, 1.97-3.47; P.001) and not to patients with drug-associated hypoglycemia (HR, 1.06; 95% CI, 0.74-1.52; P.749).
· After adjustment for patient comorbidities, the association between spontaneous hypoglycemia and mortality was eliminated (HR, 1.11; 95% CI, 0.76-1.64; P.582).
Similar data was previously reported by Kosiboroh et al in Jama a couple of years ago/