FREQUENCY OF HYPOGLYCEMIA ON A SPECIALIZED DIABETES WARD AND WATCHDOGFUNCTIONS

Despite the fact that even mild episodes of hypoglycaemia may result i n serious disturbance of metabolic control, only few studies have been published concerning the rates of biochemical hypoglycaemia on diabet es wards. There are only few attempts to identify predictors for hypog lycaemic events. Therefore, the frequency of hypoglycaemia on a specia lized diabetes ward has been investigated collecting blood glucose pro files (seven measurements per patient per day) under routine condition s; 2131 blood glucose measurements in 51 patients with insulin-depende nt diabetes mellitus (IDDM) have been evaluated retrospectively with r espect to their time pattern including modal day. The total incidence of near hypoglycaemic events (blood glucose < 60 mg/dl (3.3 mM)) was f ound to be 4.3%. The risk of hypoglycaemia is increased by a factor of 2.8 if hypoglycaemia had occurred 24 hours earlier. A set of 30 watch dog rules to predict the risk of hypoglycaemia was implemented. These watchdog functions were evaluated retrospectively on the set of 2131 b lood glucose measurements. The sensitivity for detecting critical tren ds depends on the time of day: 9 out of 16 nocturnal hypoglycaemic eve nts were detected early whereas none of the 7 hypoglycaemic events at bedtime could be anticipated in the late afternoon. The results indica te that the use of optimized watchdog functions may be able to prevent the major part of hypoglycaemic events under routine conditions on a diabetes ward.