PMID- 29473001
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231105
IS  - 2167-8359 (Print)
IS  - 2167-8359 (Electronic)
IS  - 2167-8359 (Linking)
VI  - 6
DP  - 2018
TI  - Body mass index influences the plasma glucose concentration during iatrogenic 
      hypoglycemia in people with type 2 diabetes mellitus: a cross-sectional study.
PG  - e4348
LID - 10.7717/peerj.4348 [doi]
LID - e4348
AB  - BACKGROUND: Hypoglycemia occurs in an appreciable number of individuals with type 
      2 diabetes mellitus (T2DM) who are receiving glycemic therapy. Iatrogenic 
      hypoglycemia induces not only complications but also a substantial medical 
      expense. Intervention for relevant risk factors may help avert severe 
      hypoglycemia and enhance quality of life in at-risk individuals. This study 
      investigates the relationship between body mass index (BMI) and plasma glucose 
      concentration during iatrogenic hypoglycemia in people with T2DM. METHODS: 
      Enrollment criteria were people above 20 years of age, with existing diagnosis of 
      T2DM, a documented plasma glucose level </=70 mg/dL, and acute cognitive impairment 
      requiring hospitalization. Participants were classified into two groups according 
      to their BMI. Specifically, lower BMI subgroup denotes individuals whose BMI fall 
      within lower half of the study population, and vice versa. Plasma glucose 
      concentration, length of hospital stay, and serum electrolyte level at 
      hospitalization were compared between these BMI subgroups. Moreover, multivariate 
      regression analysis was performed to identify covariates associated with plasma 
      glucose level during iatrogenic hypoglycemia. RESULTS: This study enrolled 107 
      participants for whom 54 were assigned to a higher BMI subgroup and the remainder 
      to a lower BMI subgroup. People with lower BMI harbored substantially reduced 
      plasma glucose concentration during iatrogenic hypoglycemia compared to those 
      with higher BMI (30.1 +/- 9.6 mg/dL vs. 38.4 +/- 12.3 mg/dL, P < 0.001). Nonetheless, 
      the length of stay (6.2 +/- 4.6 days vs. 5.7 +/- 4.0 days, P = 0.77) and serum 
      potassium level (3.7 +/- 0.9 meq/L vs. 3.9 +/- 0.8 meq/L, P = 0.14) were comparable 
      between subgroups. Multivariate regression analysis identified BMI as a 
      determinant of plasma glucose concentration in diabetic individuals with 
      iatrogenic hypoglycemia (beta coefficient: 0.72, P = 0.008). DISCUSSION: In 
      individuals with T2DM who experience severe iatrogenic hypoglycemia, BMI 
      influences the plasma glucose level at hospitalization. People with lower BMI 
      harbored appreciably reduced plasma glucose concentration relative to their 
      higher BMI counterparts. In lower weight people, therefore, appropriate dosing of 
      antidiabetic medications, frequent self-monitoring of blood glucose level and 
      adequate nutritional support may help avert more severe hypoglycemia. Overall, 
      BMI potentially influences the severity of iatrogenic hypoglycemia in people with 
      T2DM.
FAU - Cheng, Po Chung
AU  - Cheng PC
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, 
      Changhua Christian Hospital, Changhua City, Taiwan.
FAU - Hsu, Shang Ren
AU  - Hsu SR
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, 
      Changhua Christian Hospital, Changhua City, Taiwan.
FAU - Tu, Shih Te
AU  - Tu ST
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, 
      Changhua Christian Hospital, Changhua City, Taiwan.
FAU - Cheng, Yun Chung
AU  - Cheng YC
AD  - Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan.
FAU - Liu, Yu Hsiu
AU  - Liu YH
AD  - Department of Accounting and Information Systems, National Taichung University of 
      Science and Technology, Taichung, Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20180215
PL  - United States
TA  - PeerJ
JT  - PeerJ
JID - 101603425
PMC - PMC5816962
OTO - NOTNLM
OT  - Body mass index
OT  - Complications
OT  - Hypoglycemia
OT  - Type 2 diabetes mellitus
COIS- The authors declare there are no competing interests.
EDAT- 2018/02/24 06:00
MHDA- 2018/02/24 06:01
PMCR- 2018/02/15
CRDT- 2018/02/24 06:00
PHST- 2017/12/15 00:00 [received]
PHST- 2018/01/19 00:00 [accepted]
PHST- 2018/02/24 06:00 [entrez]
PHST- 2018/02/24 06:00 [pubmed]
PHST- 2018/02/24 06:01 [medline]
PHST- 2018/02/15 00:00 [pmc-release]
AID - 4348 [pii]
AID - 10.7717/peerj.4348 [doi]
PST - epublish
SO  - PeerJ. 2018 Feb 15;6:e4348. doi: 10.7717/peerj.4348. eCollection 2018.