High-risk factors for disorders of consciousness of hypoglycemia

Abstract

Objective To explore the high risk factors and causes of disorders of consciousness (DOC) in hypoglycemia patients. Methods A total of 108 patients receiving hypoglycemia treatment in Chongqing Renji Hospital and Chongqing Emergency Medical Center from January 2010 to December 2020 were enrolled in this study. The relationships of sex, age, insulin injection or administration of sulfonylurea drugs and alcohol consumption with hypoglycemia were analyzed. According to being conscious or not, the patients were divided into DOC group (n=72) and non-DOC group (n=36). The differences of being diabetes mellitus or not, blood glucose level, hypoglycemia duration, and complications (diabetes, hypertension, chronic obstructive pulmonary disease, coronary heart diseases, nephropathy, sequelae of stroke and tumors) were compared between the 2 groups. The causes of DOC by hypoglycemia and outcome after glucose raising treatment were analyzed in combination with CT images and results of electroencephalography (EEG). Results The 108 hypoglycemia patients were majorly old aged (89.8%, over 60 years old) and had diabetes mellitus (70.4%). Seventy-two of them (66.7%) were complicated with DOC, and about 54.17% of them took sulfonylurea hypoglycemic drugs, which was the main inducement of hypoglycemic DOC. Compared with the non-DOC group, the blood glucose level was obviously reduced and the duration of hypoglycemia was notably longer in the DOC group, but the ratio of patients with diabetes mellitus combined with hypertension were significantly less, while the ratio of patients with the 2 above diseases with hypertension and another one or more complications simultaneously (such as chronic obstructive pulmonary inflammation, coronary heart diseases, kidney disease, stroke sequelae, and tumor, etc.) were significantly larger. There were no significant differences in age, sex and serum creatinine between the 2 groups. In addition, no statistical differences were seen in CT images and EEGs after recovery from DOC. After the treatment of glucose, no obvious sequelaes occurred and the improvement rate was quite high. Conclusion The main inducement of hypoglycemic DOC is oral administration of sulfonylurea, and the main high-risk factors are the severity of hypoglycemia, duration of hypoglycemia and having 3 or more complications. The patients with both diabetes mellitus and hypertension are relatively not so easy to develop hypoglycemic DOC.

Keywords

• hypoglycemia
• disorders of consciousness
• risk factors