Prevalence and correlates of severe hypoglycaemia among patients with youth onset diabetes in India (AD-1544)

Background and aim: Hypoglycaemia is the most common acute complication in type 1 diabetes. It may also occur in type 2 diabetes when treatment includes insulin or insulin secretagogues. The threat of incidence of hypoglycaemia is the limiting factor for intensive glycaemic control in diabetes management. The aim of the present study was to ascertain the burden and risk factors of hypoglycaemia among youth onset diabetes patients in India.

Methods: A cross sectional study was conducted among patients with youth onset type 1 and type 2 diabetes registered at the All India Institute of Medical Sciences (AIIMS), New Delhi and Madras Diabetes Research Foundation (MDRF), Chennai centres of the registry of people with youth onset diabetes in India (YDR). The patients who attended the above clinics between 1st July 2013 and 31st July 2015 were invited to participate in the study. History of hypoglycaemia was captured using a structured questionnaire and the categories were defined as per the American Diabetes Association’s hypoglycaemia working group recommendations. Self-care activities [physical activity (30 minutes of moderate to vigorous activity), adherence to diet plan and self-monitoring of blood glucose (SMBG)] were assessed using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire, which is a brief questionnaire that asks how many days per week an activity was performed.

Results: The prevalence of probable symptomatic hypoglycaemia in type 1 and type 2 diabetes patients, who attended two tertiary care hospitals in India, was 50.8 % and 45.5% respectively. The prevalence of severe hypoglycaemia was significantly higher among type 1 diabetes patients with 13.4% of them having at least one episode in the previous year. The factors associated with severe hypoglycaemia in type 1 diabetes patients were irregular self-monitoring of blood glucose [adjusted odds ratio (95% C.I) - 4.5 (2.1, 9.5)] and non-adherence to the prescribed weekly diet plan [adjusted odds ratio (95% C.I) - 2.5 (1.4, 4.0)]. The study was not powered enough to analyse the risk factors of hypoglycaemia in patients with youth onset type 2 diabetes. 

Discussion: There is high burden of symptomatic hypoglycaemia among patients with youth onset type 1 and type 2 diabetes from India. This study highlights the importance of educating patients with youth onset diabetes and their families in terms of hypoglycaemia and its risk factors. The study results further emphasize the role of healthy diet as well as self-monitoring of blood glucose in the optimal diabetes management.