Hipos-ER (Hypoglycemia in Portugal Observational Study – Emergency Room): Outcomes with Different Anti-Hyperglycemic Agents

HIPOS-ER is an observational study to describe the patient population of Type 2 Diabetics treated with an anti-hyperglycemic agent (AHA) and admitted to the emergency room (ER) with a hypoglycemic event. In this analysis we aim to describe the hypoglycemia events by AHA class. The study enrolled patients from 7 centers in mainland Portugal from Jan 2013 – Jan 2014. Sociodemographic and clinical data were collected at the emergency room and patients who required hospital admission were followed up. Episodes were enrolled consecutively within the sampling period. AHA therapy classes were Insulin - Group 1, secretagogue based - Group 2, oral AHA excluding secretagogue - Group 3 and Insulin+secretagogue – Group 4. A total of 238 patients were admitted to the ER with severe hypoglycemia and 105 (44%) were hospitalized. The distribution based on AHA therapy: 55% (131) Group 1,32% (75) Group 2,7% (16) Group 3 and 7% (16) Group 4. Previous severe hypoglycemia in the last 12 months was more frequent in Group 1 vs. Group 2 (p=0.009). Group 2 patients were more often followed up in Primary Care vs. Group 1 (84% vs. 48%; p<0.001) and Group 4 (44%, p=0.002). Group 2 patients were more often hospitalized vs. Group 1 (71% vs. 29%; p<0.001) and Group 4 (31%; p=0.003). There was no difference in terms of the length of stay or hospitalization outcome. 9 deaths occurred: 5 in Group 1,3 in Group 2 and 1 in Group 3. In the first national study on severe hypoglycemia in Type 2 diabetics, patients treated with Group 2 drugs were followed mainly in Primary care setting. More patients on Group 2 drugs were hospitalized. Within our sample there is little clinical difference in the hypoglycemia events with different therapys besides the need for hospitalization.