Incidence of severe hypoglycemia and its causes in insulin-treated diabetics.

In a one-year prospective study in insulin-treated diabetics, 61 episodes of severe hypoglycemia demanding medical assistance were registered in 46 patients. The incidence of severe hypoglycemia was estimated at 0.07 per patient and year. Mean age (50 +/- 16.9 yr), diabetes duration (19 +/- 11.6 yr), HbAlc (7.8 +/- 1.8%) and daily insulin dose (0.63 +/- 0.23 IU/kg) in these patients (SH group) did not differ from a control group matched for sex and age. However, the patients in the SH group were treated with relatively less short-acting insulin than the patients in the control group (25 +/- 13.8% vs. 39 +/- 24.5%; p less than 0.01). This finding may indicate that multiple injection therapy with a higher relative amount of short-acting insulin could reduce the risk of severe hypoglycemia, provided the metabolic control is unaltered.