Diurnal temporal patterns of hypoglycaemia in hospitalized people with diabetes may reveal potentially correctable factors.

AIM

To determine whether diurnal temporal variations in hypoglycaemic frequency occur in hospitalized patients.

METHODS

Hypoglycaemic events were identified in a snapshot bedside audit of capillary blood glucose results from diabetes charts of all inpatients receiving insulin or a sulphonylurea (with or without insulin) on 2 days separated by 6 weeks. Additionally, capillary blood glucose measurements were remotely captured over 2 months, in the same category of patients, and analysed for temporal patterns. Hypoglycaemia was defined as 'severe' when the capillary blood glucose was < 3.0 mmol/l and 'mild' when the capillary blood glucose was between 3.0 and 3.9 mmol/l.

RESULTS

The bedside audit found that 74% of those audited experienced a hypoglycaemia event. Eighty-three per cent of all hypoglycaemic events and 70% of severe events were recorded between 21.00 and 09.00 h. This was confirmed in the longer duration remote monitoring study where 70% of all hypoglycaemic events and 66% of severe events occurred between 21.00 and 09.00 h.

CONCLUSION

Hypoglycaemia occurs more frequently between 21.00 and 09.00 h in hospitalized patients receiving treatments that can cause hypoglycaemia. This may be related to insufficient carbohydrate intake during this period, and is potentially preventable by changes in catering practice.