Hypoglycemic episodes (HEs) are a major treatment related side effect among patients with diabetes. It's a risk factor for cardiovascular adverse events and affects quality of life.
To identify socio-economic risk factors for HEs among young adults with diabetes.
A sample of 1007 young Sri Lankan adults with diabetes (age 20- 45 years) were randomly selected and their socio-economic details such as ethnicity, educational level, income and details on HEs were recorded. Correlation between socio-economic variables and HEs were analyzed using Pearson Chi square analysis.
Overall 42.3% were males. Mean age was 36.6 (±5.8) years. Mean fasting blood sugar and HbA1c were 165.6 (±69.3) mg/dl and 8.0% (±2.0%) respectively. Patients who had never experienced a HE and those who were experiencing less than one HE per month overall were 42.2% and 67.5% respectively. Daily hypoglycemia was reported in 4.9%. A history of hospital admission for hypoglycemia was present in 3.5%. Only 21.7% of males reported one or more HEs per month while 40.3% of females reported the same (p<0.01). One or more HEs per month were recorded in less patients with Indian Tamil ethnicity (25%) than Sinhala (30.6%), Sri Lankan Tamil (44.4%) or Muslim (44.8%) ethnicities (p<0.05). Only 19.4% of patients with a monthly income over 25,000 LKR (158 USD) developed one or more HEs per month while 35.8% of patients with an income less than this developed the same (p<0.01). Incidence of hypoglycemia in patients educated up to GCE Ordinary level exam (37.6%) was twice that of those who had had a higher education (19.5%) (p<0.01).
Female gender, ethnicity, monthly income <25,000 LKR and low education level are risk factors for HEs in young adults with diabetes. Closer follow up and adjustment of treatment regimens may be indicated in these high risk categories.