Biomedical papers, 2012 (vol. 156), issue 3

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2012, 156(3):271-277 | 10.5507/bp.2012.037

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

Veronika Krnacovaa, Ales Kubenaa,b, Karel Maceka,c, Martin Bezdekd, Alena Smahelovae,f, Jiri Vlceka,g
a Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University in Prague, Hradec Kralove, Czech Republic
b Institute of Information Theory and Automation, Czech Academy of Sciences in Prague
c Center of Clinical Pharmacology, Teaching Hospital in Hradec Kralove
d Emergency Medical Service in Hradec Kralove
e Center of Diabetology, Teaching Hospital in Hradec Kralove
f Faculty of Medicine in Hradec Kralove, Charles University in Prague
g 2nd department of medicine, Teaching Hospital in Hradec Kralove

Aims: To evaluate the incidence of severe hypoglycaemia (SH) requiring the assistance of Emergency Medical Services (EMS) in the general population of the Hradec Králové region, in a 1 year period; to describe the distribution of these events throughout the day, and to analyse the symptoms and causes.

Methods: The outcome data were obtained from special forms which were filled in by EMS medical staff. Incidence of SH was calculated and the distribution of events throughout the day was analysed using contingency tables. The relationship between blood glucose levels and the presence or absence of causes and symptoms of hypoglycaemia was evaluated using a general linear model and the regression tree technique.

Results: In all, a total of 338 events of SH were recorded in 262 patients. 150 episodes appeared in type 2 diabetic patients, 83 episodes in type 1 diabetic patients. 258 events were documented in insulin-treated patients. The incidence of SH was 2.4 and 0.4 episodes/100 patients/year for type 1 and type 2 diabetic patients, respectively. A significantly greater number of hypoglycaemic episodes was documented between 2 pm and 6 pm (P<0.001). Insulin therapy and alcohol consumption were the most dangerous causes of SH.

Conclusions: Hypoglycaemia requiring the assistance of EMS represents an essential problem, especially in type 1 diabetic patients. The percentage of SH is comparable to other frequent diagnoses requiring the assistance of EMS in the region. This study reflects the behaviour of diabetic patients and highlights information which is important in the prevention of SH.

Keywords: severe hypoglycaemia, emergency medical service, regression trees, causes, symptoms, incidence

Received: July 30, 2011; Accepted: February 29, 2012; Prepublished online: May 25, 2012; Published: September 1, 2012


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