How Common Is Hypoglycemia After ICU Discharge?

In patients with type 2 diabetes who have been discharged from intensive care units (ICUs), hypoglycemia is common and frequently occurs overnight, according to a recent study.

There is limited information available on glycemic control in ICU survivors with type 2 diabetes, according to the study authors. To explore this further, they conducted a prospective, observational, 2-center study involving 31 individuals who underwent blinded continuous interstitial glucose monitoring and ambulatory electrocardiogram monitoring immediately following ICU discharge. All participants had type 2 diabetes and were prescribed subcutaneous insulin. They had all spent 24 hours or more in ICU with failure of one or more organs.

Overall, hypoglycemia was observed in 12 participants (39%) and was more likely to be nocturnal (40 of 51 hours) and asymptomatic (25 of 29 episodes). Hypoglycemia was associated with increased risk of bradycardia but did not impact atrial or ventricular ectopics, heart rate variability, or cardiac repolarization.

“In ICU survivors with insulin-treated type-2 diabetes, hypoglycemia occurs frequently and is predominantly nocturnal, asymptomatic, and prolonged,” the researchers concluded.

—Michael Potts

Reference:

Ali Abdelhamid Y, Bernjak AM, Phillips LK, et al. Nocturnal hypoglycemia in patients with diabetes discharged from ICUs: a prospective two-center cohort study. Crit Car Med. 2021. 49(4):636-649. doi: 10.1097/CCM.0000000000004810.