[ASSOCIATION BETWEEN TREATMENT FOR DIABETES MELLITUS AND HYPOGLYCEMIA AMONG HOSPITALIZED PATIENTS WITH HYPOALBUMINEMIA TREATED WITH MEDICAL FOOD].

Abstract

Introduction: Hypoglycemia may be related to malnutrition or treatment of diabetes. An association between treatment with medical food and lower incidence of hypoglycemia among patients with diabetes and hypoalbuminemia has recently been shown.

Aims: To study the association between hypoglycemia incidence and medical and nutrition treatment for diabetes.

Methods: In this observational study, data was collected from electronic medical records. Included were patients with type 2 diabetes, admitted to internal medicine "E" at the Edith Wolfson Medical Center between 1.6.2016-31.5.2017. Logistic regression was implemented to assess the association between treatment for diabetes and hypoglycemia. Linear regression models were built to examine the association between treatment for diabetes and the number of hypoglycemic events.

Results: Included were 221 patients (62.4% females, mean age 77.4 ± 12.0 years), 52 of them (23.5%) had hypoglycemia. The proportion of patients on medical food was 69.5±37.1%. According to logistic regression model, age (OR 1.034, CI 1.002-1.068, p=0.038), male sex (OR 2.941, CI 1.454-5.945, p=0.003) and treatment with insulin (OR 3.778, CI 1.831-7.794, p<0.001) were associated with hypoglycemia, while treatment with medical food was associated with less hypoglycemia (OR 0.352, CI 0.145-0.857, p=0.022). The linear regression model showed that metformin was associated with fewer hypoglycemic events (beta=-0.352 CI -1.391- -0.704, p<0.001). Nutrition was not found to be associated with the number of hypoglycaemic events.

Conclusions: Treatment with oral nutrition supplements and metformin is associated with reduced incidence of hypoglycemia.

Discussion: Oral nutrition is crucial for preventing hypoglycaemia during hospitalizations, regardless of the treatment for glucose control. Metformin is also beneficial.