Hypoglycemia Among Type 1 Diabetes Patients After Insulin Use in Southwest Ethiopia

Introduction: Glycemic control is a valuable goal for people with diabetes; however, the greatest challenge to achieve tight glycemic control is hypoglycemia. Hypoglycemic events are probably common in type 1 diabetes, however, little is known about hypoglycemia in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of hypoglycemia among type 1 diabetes (T1D) patients after insulin use at Metu Karl Referral Hospital in southwest Ethiopia. Materials and Methods: A hospital-based cross-sectional study was conducted among 242 T1D patients at Metu Karl Referral Hospital in southwest Ethiopia. The prevalence of hypoglycemia was assessed by a structured questionnaire through a face-to-face interview in which all the possible symptoms of hypoglycemia were included. If patients reported that they had experienced the symptoms at least 2 times in a month and the symptoms relieved on consuming sugar/ candy/honey were considered to have had a hypoglycemic episode. Binary logistic regression analysis was done to identify the factors associated with the occurrence of hypoglycemia. Results: Out of 242 T1D patients interviewed, 114 (47.1%) had self-reported hypoglycemia. The most reported symptom of hypoglycemia was sweating (91.7%) followed by dizziness and hunger and nausea with the prevalence of 24.8% and 14.5%, respectively. The study also found educational level with read and write up to primary (AOR = 0.41, 95% CI [0.19-0.88]) and secondary and above (AOR = 0.32, 95% CI [0.14-0.70]), poor knowledge of diabetes (AOR = 2.26, 95% CI [1.06-4.84]), good knowledge of insulin self-administration (AOR = 0.54, 95% CI [0.30- 0.99]) and duration of insulin use ≥ 5 years (AOR = 3.93, 95% CI [1.44-10.7]) were factors associated with hypoglycemia. Conclusions: The prevalence of hypoglycemia was found remarkable. We can conclude that hypoglycemia is of public health importance among T1D patients. Since the study assesses hypoglycemia after insulin injection, this prevalence may be due to the poor practice of insulin injection. Therefore, imparting education on the proper insulin administration technique should be considered at each follow-up visit.