Higher incidence of severe hypoglycaemia leading to hospital admission in Type 2 diabetic patients treated with long‐acting versus short‐acting sulphonylureas

Abstract

Summary: Aims A comparison of the frequency of severe hypoglycaemia leading to hospital admission in people with Type 2 diabetes mellitus (DM) treated with long vs. short‐acting sulphonylureas. Methods A community based study over a 12‐year period in the population of the city of Basle, Switzerland. The number of diabetic patients treated with oral hypoglycaemic agents was established on the basis of tablet consumption and a defined daily dose, e.g. 7.5 mg for glibenclamide, and 50 mg for glibornuride. Results Twenty‐eight Type 2 diabetic patients were admitted for severe hypo‐ glycaemia, with a median age of 73 years. There were no deaths. Sixteen of these admissions were patients treated with long‐acting sulphonylureas and 12 were patients treated with short‐acting forms. Only 23.5% of the population with Type 2 DM in Basle were treated with long‐acting sulphonylureas. With 30 345 person‐years of observation, the incidence of severe hypoglycaemia was 2.24 per 1000 person‐years for long‐acting sulphonylureas vs. 0.75 per 1000 person‐year for short‐acting forms, odds ratio 3.01 (95% confidence interval 1.35–6.77). Decreased food intake (nine patients) was a major contributing factor. Conclusions Severe hypoglycaemia leading to hospital admission is more common in elderly Type 2 diabetic patients treated with long‐acting compared to short‐acting sulphonylureas. Such long‐acting sulphonylureas should be avoided.