Severe hypoglycaemia requiring the assistance of emergency medical services - frequency, causes and symptoms

Krnacova, Veronika; Kubêna, Aleŝ; Macek, Karel; Bezdek, Martin; Šmahelová, Alena; Vlcek, Jirí

doi:10.5507/bp.2012.037

Cited by 10 publications

(9 citation statements)

References 35 publications

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“…Pareto analysis for population FRIDs was applied using the ATC codes recursively up to the second level; at each level, the frequency had to achieve at least 60% of drugs to proceed the next Pareto analysis of the lower ATC level. Multivariate analysis, specifically the tree-based technique (Krnacova et al, 2012), was performed to analyse dependencies of the metric variables (differences in the physicians' and pharmacists' opinions) on a larger number of non-independent binary variables (presence of FRIDs). P-value < 0.05 was considered as statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Pharmacotherapy as major risk factor of falls - analysis of 12 months experience in hospitals in South Bohemia

Malý¹,

Doseděl²,

Vosátka³

et al. 2019

JAB

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This study aimed to analyze the effect of fall risk-increasing drugs (FRIDs) and drug-related factors relative to falls through clinical pharmacy service in hospitalized patients, focusing on the relevance of clinical pharmacist evaluation in the context of physician assessment. A prospective study of inpatient falls was conducted in 2017 retrieving data from 4 hospitals in South Bohemia, Czech Republic. An online database was developed to collect patient and fall-related data, and fall evaluation records. Healthcare professionals classified the overall effect of drugs on falls using Likert scale. Univariate and multivariate correlations were performed with a significance level of p < 0.05. Out of the total 280 falls (mean age of patients 77.0 years), a mean of 2.8 diagnoses with fall-related risk, 8.8 drugs, and 4.1 FRIDs per fall were identified. Incidence of falls decreased quarterly (p < 0.001). Use of FRIDs were positively associated with increasing age (p = 0.007). Clinical pharmacists were more likely to identify pharmacotherapy as the relevant fall-related risk, compared to physicians evaluation (p < 0.001). An increasing total number of prescribed drugs as well as higher number of FRIDs increased the suspicion in both professionals in the context of drug-related causes of falls.

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Section: Discussionmentioning

confidence: 99%

Pharmacotherapy as major risk factor of falls - analysis of 12 months experience in hospitals in South Bohemia

Malý¹,

Doseděl²,

Vosátka³

et al. 2019

JAB

Self Cite

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“…The complexity of treatment regimens with insulin, associated with the need for greater attention to glycemic control, may explain the higher incidence of hypoglycemic events in patients under this type of treatment 22 , 33 . The use of simpler regimens and insulin analogs can minimize these risks 46 .…”

Section: Discussionmentioning

confidence: 99%

Risk factors for unstable blood glucose level: integrative review of the risk factors related to the nursing diagnosis

Teixeira¹,

Tsukamoto

Lopes

et al. 2017

Rev. Latino-Am. Enfermagem

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Objective:to identify evidence in the literature on the possible risk factors for the risk of unstable blood glucose diagnosis in individuals with type 2 diabetes mellitus, and to compare them with the risk factors described by NANDA International. Method:an integrative literature review guided by the question: what are the risk factors for unstable blood glucose level in people with type 2 diabetes mellitus? Primary studies were included whose outcomes were variations in glycemic levels, published in English, Portuguese or Spanish, in PubMed or CINAHL between 2010 and 2015. Results:altered levels of glycated hemoglobin, body mass index>31 kg/m2, previous history of hypoglycemia, cognitive deficit/dementia, autonomic cardiovascular neuropathy, comorbidities and weight loss corresponded to risk factors described in NANDA International. Other risk factors identified were: advanced age, black skin color, longer length of diabetes diagnosis, daytime sleepiness, macroalbuminuria, genetic polymorphisms, insulin therapy, use of oral antidiabetics, and use of metoclopramide, inadequate physical activity and low fasting glycemia. Conclusions:risk factors for the diagnosis, risk for unstable blood glucose level, for persons with type 2 diabetes mellitus were identified, and 42% of them corresponded to those of NANDA International. These findings may contribute to the practice of clinical nurses in preventing the deleterious effects of glycemic variation.

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“…Krnacova et al . [13] study showed that most hypoglycemic episodes were experienced by patients between 2 pm and 6 pm. Another study reported that the lowest glycemia occurred just before the evening meal.…”

Section: Discussionmentioning

confidence: 99%

A retrospective study on epidemiology of hypoglycemia in Emergency Department

Kumar

Abhilash

Saya

et al. 2017

Indian J Endocr Metab

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Background:Hypoglycemia is one among the leading causes for Emergency Department (ED) visits and is the most common and easily preventable endocrine emergency. This study is aimed at assessing the incidence and elucidating the underlying causes of hypoglycemia.Materials and Methods:A retrospective, observational study which included patients registering in ED with a finger prick blood glucose ≤60 mg/dl at the time of arrival. All patients aged above 15 years with the above inclusion criteria during the period of August 2010 to July 2013 were selected. The study group was categorized based on diabetic status into diabetic and nondiabetic groups.Results:A total of 1196 hypoglycemic episodes encountered at the ED during the study period were included, and of which 772 with complete data were analyzed. Underlying causes for hypoglycemia in the diabetic group (535) mainly included medication related 320 (59.81%), infections 108 (20.19%), and chronic kidney disease 61 (11.40%). Common underlying causes of hypoglycemia in nondiabetic group (237, 30.69%) included infections 107 (45.15%), acute/chronic liver disease 42 (17.72%), and malignancies 22 (9.28%). Among diabetic subjects on antidiabetic medications (n = 320), distribution over 24 h duration clearly reported two peaks at 8th and 21st h. The incidence of hypoglycemia and death per 1000 ED visits were 16.41 and 0.73 in 2011, 16.19 and 0.78 in 2012, 17.20 and 1.22 in 2013 with an average of 16.51 and 0.91, respectively.Conclusion:Bimodal distribution with peaks in incidences of hypoglycemic attacks at 8th and 21st h based on hourly distribution in a day can be correlated with the times just before next meal. None of the patients should leave ED without proper evaluation of the etiology of hypoglycemia and the problem should be addressed at each individual level. Increasing incidence of death over the years is alarming, and further studies are needed to conclude the root cause.

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Severe hypoglycaemia requiring the assistance of emergency medical services - frequency, causes and symptoms

Cited by 10 publications

References 35 publications

Pharmacotherapy as major risk factor of falls - analysis of 12 months experience in hospitals in South Bohemia

Pharmacotherapy as major risk factor of falls - analysis of 12 months experience in hospitals in South Bohemia

Risk factors for unstable blood glucose level: integrative review of the risk factors related to the nursing diagnosis

A retrospective study on epidemiology of hypoglycemia in Emergency Department

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