We analysed data obtained from electronic patient records from inpatients with diabetes admitted to a large university hospital.
The study was conducted using electronic patient record data from Oxford University Hospitals NHS Foundation Trust. The dataset contains hospital admission data for patients with diabetes. We define a biochemical hypoglycemic episode as any blood glucose measurement < 4mmol/l and a clinically significant hypoglycemic episode as any blood glucose measurement <3mmol/l. Any two or more than two consecutive low blood glucose within a 4-hour time window are considered as one hypoglycemic episode.
We analyzed data obtained from 17,658 inpatients with diabetes [1,696 type 1 diabetes, 14,006 type 2 diabetes, 9,277 males, age 66(18) years, mean(SD)] who underwent 32,758 hospital admissions between 2014 and 2018. We identified all the biochemical and clinically significant hypoglycemic episodes during these admissions. The incidence of biochemical hypoglycemia was 21.5% and that of clinically significant hypoglycemia was 9.6%. Major findings from the data analysis include: Recurrent biochemical and clinically significant hypoglycemia happened during 50% and 39% of hospital admissions with at least one hypoglycemic episode; Patients on metformin alone had the lowest incidence of hypoglycemia(8%) comparing to those on rapid analogue, long analogue and human rapid insulin at the same time, with the highest incidence (53%); Incidence of biochemical hypoglycaemia in type 1 diabetes(37%) doubles that in type 2 diabetes(18%).
Retrospective analysis of data from electronic patient records helps gain clinical understanding about inpatient hypoglycaemia and may improve inpatient glycaemic control through targeting high-risk hypo-prone inpatients.