Higher incidence of severe hypoglycaemia leading to hospital admission in Type 2 diabetic patients treated with long-acting versus short-acting sulphonylureas

Diabet Med. 1999 Jul;16(7):586-90. doi: 10.1046/j.1464-5491.1999.00110.x.

Abstract

Aims: A comparison of the frequency of severe hypoglycaemia leading to hospital admission in people with Type 2 diabetes mellitus (DM) treated with long vs. short-acting sulphonylureas.

Methods: A community based study over a 12-year period in the population of the city of Basle, Switzerland. The number of diabetic patients treated with oral hypoglycaemic agents was established on the basis of tablet consumption and a defined daily dose, e.g. 7.5 mg for glibenclamide, and 50 mg for glibornuride.

Results: Twenty-eight Type 2 diabetic patients were admitted for severe hypoglycaemia, with a median age of 73 years. There were no deaths. Sixteen of these admissions were patients treated with long-acting sulphonylureas and 12 were patients treated with short-acting forms. Only 23.5% of the population with Type 2 DM in Basle were treated with long-acting sulphonylureas. With 30345 person-years of observation, the incidence of severe hypoglycaemia was 2.24 per 1000 person-years for long-acting sulphonylureas vs. 0.75 per 1000 person-year for short-acting forms, odds ratio 3.01 (95% confidence interval 1.35-6.77). Decreased food intake (nine patients) was a major contributing factor.

Conclusions: Severe hypoglycaemia leading to hospital admission is more common in elderly Type 2 diabetic patients treated with long-acting compared to short-acting sulphonylureas. Such long-acting sulphonylureas should be avoided.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Confidence Intervals
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Emergencies
  • Female
  • Glyburide / adverse effects*
  • Hospitals, University / statistics & numerical data
  • Humans
  • Hypoglycemia / chemically induced*
  • Hypoglycemia / epidemiology*
  • Hypoglycemic Agents / adverse effects*
  • Incidence
  • Inpatients / statistics & numerical data
  • Male
  • Middle Aged
  • Odds Ratio
  • Retrospective Studies
  • Sulfonylurea Compounds / adverse effects*
  • Switzerland / epidemiology

Substances

  • Hypoglycemic Agents
  • Sulfonylurea Compounds
  • glibornuride
  • Glyburide