Severe hypoglycaemia in drug-treated diabetic patients needs attention: a population-based study

Scand J Prim Health Care. 2011 Sep;29(3):165-70. doi: 10.3109/02813432.2011.580090. Epub 2011 Jun 15.


Objective: To study one-year incidence and risk factors of severe hypoglycaemias (SH) in adult drug-treated diabetic patients living in two Finnish communities.

Design: The episodes of SH and their risk factors were identified from local ambulance registers, from the databases of local health care units, and from patient questionnaires.

Setting: The target population consisted of all drug-treated diabetic patients from the two middle-sized communities in southern Finland, altogether 1776 patients. The study was retrospective.

Subjects: A total of 1469 patients (82.7% of the target population) gave informed consent for the use of their medical records and 1325 patients (74.6% of the target population) returned the detailed 36-item questionnaire.

Results: Of type 1 and type 2 insulin-treated diabetic patients, 14.6% and 1.0%, respectively, needed ambulance or emergency room care (incidence of 30.5 and 3.0 per 100 patient years). However, 31.0% of type 1 and 12.3% of type 2 diabetic patients reported at least one episode of SH (incidence of 72.0 and 27.0 per 100 patient years). Of all insulin-treated patients, 53 (7.8%) reported three or more episodes of SH. Significant independent risk factors for SH were depression, daily exercise, and nephropathy but not glycaemic control.

Conclusion: The incidence of SH was high in both types of insulin-treated diabetic patients. However, the recurrent episodes of SH were clustered in a small minority of insulin-treated patients with diabetes. The risk of SH should be considered when assessing the treatment target for an individual diabetic patient.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Emergencies
  • Humans
  • Hypoglycemia / diagnosis
  • Hypoglycemia / etiology*
  • Hypoglycemia / therapy
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / adverse effects
  • Insulin / administration & dosage
  • Insulin / adverse effects
  • Insulin Coma / diagnosis
  • Insulin Coma / etiology
  • Insulin Coma / therapy
  • Middle Aged
  • Recurrence
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Self Report
  • Surveys and Questionnaires


  • Hypoglycemic Agents
  • Insulin