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Revista Uruguaya de Medicina Interna

On-line version ISSN 2393-6797

Abstract

BRUNO, Lorena et al. Unnoticed hypoglycemia and severe hypoglycemia in the population with Diabetes Mellitus. Rev. Urug. Med. Int. [online]. 2025, vol.10, e302.  Epub Apr 01, 2025. ISSN 2393-6797.  https://doi.org/10.26445/10.01.3.

Introduction:

Good glycemic control is essential to delay or reduce the complications of Diabetes Mellitus (DM). Hypoglycemia secondary to insulin treatment is classified according to its severity. The clinical presentation is varied and its repetition leads to low symptomatic thresholds, which can cause unnoticed hypoglycemia; the latter is associated with severe hypoglycemia. The objective of the work was to determine the prevalence of unnoticed and/or severe hypoglycemia in patients with type 1 DM and type 2 DM treated with insulin, as well as its association with the variables: age, sex, type of DM, duration of the same and type of insulin used.

Methodology:

A descriptive observational study was carried out, lasting 4 months. Unnoticed hypoglycemia was evaluated with the validated Clarke questionnaire and the definition of severe hypoglycemia was used according to the same instrument.

Results:

116 patients were recruited, 52% male, average age 42 years. 60% with DM1, with an average of 13 years of DM evolution. The most commonly used basal insulin was NPH (58.6%). Unnoticed hypoglycemia was recorded in 32.8% (66% for DM 1 and 34% for DM2) and was significantly associated with DM evolution time. In the subpopulation with DM1 (p < 0.001), severe hypoglycemia was recorded in 41.4% (65% for DM1 and 35% for DM2). A significant association between unnoticed and severe hypoglycemia was demonstrated (p < 0.001).

Conclusions:

It is proposed that new technologies in diabetes may be a tool to reduce these figures.

Keywords : Diabetes Mellitus; undetected hypoglycemia; severe hypoglycemia.

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