Objective: Hypoglycemia remains an unpredictable side effect of insulin use or oral hypoglycemic agents therapy in patients with diabetes. However, Limited data exist on the prevalence of hypoglycemia in patients attending primary care diabetes clinics. This study aimed to determine the frequency and symptoms of self-reported hypoglycemia in patients with type 2 diabetes (T2DM).

Methods: This was a cross-sectional, multicenter study conducted in three outpatient clinics in Singapore. Patients aged ≥ 21 years old with T2DM and polypharmacy were included. Patients who were unable to communicate independently were excluded. The 5-item self-reported questionnaire about hypoglycemia awareness, symptoms, frequency and measures were administered to all eligible patients.

Results: Among the 254 patients who were eligible for the study, 45.7% experienced at least one hypoglycemic episode in the past seven days. Lightheadness (24.0%) was the most common symptoms reported, followed by weakness (15.8%) and intense hunger (14.2%). Among the patients who reported hypoglycemic symptoms, 52.6% took sweets and 35.1% achieved timely relief. Of the patients who reported hypoglycemia, 11.4% suffered severe hypoglycemia, requiring the assistance of another person to take corrective actions. Overall, approximately 48.0% reported fear of low blood sugar but only 31.9% performed self-monitoring of blood sugar (SMBG) with an average monitoring frequency of 3.31 ± 3.73 times within the last seven days. The severity and frequency of self-reported hypoglydemic symptoms were not associated with HbA1c, age, body-mass index, duration of T2DM and insulin use.

Conclusion: The frequency and severity of self-reported hypoglycemia among patients with T2DM appeared to be high and unrelated to patient demographics or disease control. The use of SMBG should be emphasized among patients with T2DM regardless of type of antidiabetic agents used.


Y. Xu: None. J.Y. Lee: None.

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