Characteristics of patients treated for severe hypoglycaemia in emergency care settings - Analysis of routinely collected data.

OBJECTIVE: Severe hypoglycaemic events (SHE) commonly require emergency care. This study investigates the presentation of patients with SHE to a single Swiss emergency service, including pre-hospital care with emergency medical services (EMS) and emergency department (ED) presentations.

METHOD: Retrospective analysis of routinely collected data by the EMS and ED during 2014. All adult patients with diabetes type 1 or type 2 with SHE were included in the analysis.

RESULTS: 43 SHE were recorded in 38 patients with diabetes. Mean age of all patients was 65 years (SD ± 17.51), 54% (n = 23) were men, 55.8% (n = 24) were living in a relationship, and 54.8% (n = 23) were diagnosed with type 2 diabetes. Of the 43 episodes, 65% (n = 28) of the presentations used EMS and were then taken to the ED, 28% (n = 12) involved contact with the EMS only, and 7% (n = 3) were seen by the ED but did not use EMS. Patients seen by the EMS only (n = 12) were younger compared to those admitted to ED (n = 28); Md 54 years vs Md 72 years; U = 98; p = .039. The same age difference was similar between patients in the ED setting discharged home (n = 11) and with in-patients (n = 20); Md 61 years vs. Md 79 years; U = 51; p = .013.

CONCLUSIONS: People most likely to suffer a SHE were men, those living with a partner, over 65 years old, and living with type 2 diabetes. Younger patients treated by EMS at home tended to remain at home, in contrast to the older patients who were admitted to hospital. This was also true for the ED where older people in particular became in-patients after such an event. Elderly care specialist brief interventions conveyed by EMS and ED healthcare professionals might be of value to prevent further SHE. Validating these findings in multiple emergency settings is warranted to support the delivery of targeted interventions.