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Rivista di Medicina Interna

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,6

Periodicità: Trimestrale

ISSN 0031-0808

Online ISSN 1827-1898


Panminerva Medica 2000 Marzo;42(1):23-6


Does holiday hypoglycaemia exist?

Guagnano M. T., Pace-Palitti V., Formisano S., Della Loggia F., D’Anchino M., Della Vecchia R., Merlitti D., Sensi S.

From the Internal Medicine, Department of Medicine and Aging University of Chieti, Italy

Background. To deter­mine ­whether an exces­sive, pro­longed and, ­above all, ­unusual phys­ical exer­tion ­could be asso­ciated ­with epi­sodes of ­mild hypo­gly­caemia in non-­insulin-depen­dent diabetes mellitus (­NIDDM) ­patients ­treated ­with gli­ben­cla­mide.
Methods. Experimental ­design: 11 ­months of obser­va­tion ­with ret­ro­spec­tive anal­ysis of ­patient per­sonal ­diaries to deter­mine the hypo­gly­caemic ­risk. Setting: Diabetic Unit — Department of Medicine and Aging — Chieti University School of Medicine.
Patients: We ­enrolled 340 ­NIDDM out­pa­tients ­adjusted for sex, age, ­body ­mass ­index, ­alcohol ­intake and ­oral treat­ment reg­imen ­with gli­ben­cla­mide. Patients ­were ­tested ­monthly for cir­ca­dian ­blood glu­cose pro­files and gly­cos­y­lated hemo­globin. Mild hypo­gly­caemia was ­defined on the ­basis of ­blood glu­cose ­values <2.8 ­mmol/l asso­ciated ­with ­mild auto­nomic symp­toms, ­without ­requiring ­external assis­tance. Each dia­betic ­patient ­filled a per­sonal ­diary indi­cating the ­therapy reg­imen and the char­ac­ter­is­tics of even­tual hypo­gly­caemic epi­sodes occur­ring ­during the obser­va­tion ­period.
Results. 21.8% of ­NIDDM ­patients expe­ri­enced one or two epi­sodes of ­mild hypo­gly­caemia ­during the obser­va­tion ­period. The anal­ysis of the ­patients’ ­diaries ­showed ­that 60% of the hypo­gly­caemic epi­sodes was asso­ciated ­with exces­sive, pro­longed and unex­pected phys­ical exer­tions. Within ­this ­group, ­about 70% of the epi­sodes ­occurred ­during a hol­iday (“hol­iday hypo­gly­caemia”). After ana­lyzing the ­socio-dem­o­graphic and clin­ical char­ac­ter­is­tics of the dia­betic ­patients ­reporting hypo­gly­caemic ­events, we ­found a ­higher ­risk for “hol­iday hypo­gly­caemia” in ­patients ­with a ­lower edu­ca­tional ­level, ­with a sed­en­tary occu­pa­tion or ­among the ex-­farmers.
Conclusions. As ­resulted in the ­present ­study, unex­pected phys­ical exer­tions may rep­re­sent a rel­e­vant ­cause of ­mild hypo­gly­caemia in dia­betic ­patients ­receiving ­oral anti­di­a­betic ­therapy. However, ­this hypo­gly­caemic ­cause may ­have ­been under­es­ti­mated in the lit­er­a­ture. Educational pro­grams con­ducted by gen­eral prac­ti­tioners or dia­be­tol­o­gists ­could be ­useful for the ­patients in ­reducing the ­number of ­mild hypo­gly­caemic epi­sodes.

lingua: Inglese

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