Evidence mapPaperPMID 42010787Full record

Observational studyDiabetic medicine : a journal of the British Diabetic Association2026

Clinically significant hypoglycaemia in hospitalised adults: A multicentre study of 1205 episodes in the United Kingdom.

Charles Page, Mariam Idrissi, Sam Sherratt-Mayhew, Aashritha Buchipudi, Amanda Ling Jie Yee, Kalyaani Persad, Aqeelah Khatoon, Amrit Rakkar, Amynta Arshad, Alexandra Lubina Solomon and 7 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Diabetic medicine : a journal of the British Diabetic Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

17 authors.

Charles PageBirmingham Medical School, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Mariam IdrissiBirmingham Medical School, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Sam Sherratt-MayhewBirmingham Medical School, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Aashritha BuchipudiBirmingham Medical School, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Amanda Ling Jie YeeBirmingham Medical School, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Kalyaani PersadBirmingham Medical School, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Aqeelah KhatoonBirmingham Medical School, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Amrit RakkarBirmingham Medical School, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Amynta ArshadWarwick Hospital, Warwick, UK.
Alexandra Lubina SolomonRussells Hall Hospital, Dudley, UK.
Rajeev RaghavanThe Royal Wolverhampton NHS Trust, Wolverhampton, UK.
Lakshmi RengarajanWalsall Manor Hospital, Walsall, UK.
Ahmed IqbalDivision of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK.
Pratik ChoudharyDepartment of Population Health Sciences, George Davies Centre, University of Leicester, Leicester, UK.
Aspasia MantaDepartment of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Punith KempegowdaDepartment of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK.ORCID https://orcid.org/0000-0003-0954-6512
DEVI CollaborationDepartment of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK.

Funding

National Institute for Health and Care Research
6 · The paper itself

Abstract

INTRODUCTION AND

objectivesInpatient hypoglycaemia is a serious complication of diabetes therapy, yet real-world data on clinically significant episodes remain limited. The objectives of this study are (1) to describe the clinical and biochemical characteristics of clinically significant inpatient hypoglycaemia across multiple NHS sites, (2) to assess adherence to Joint British Diabetes Societies hypoglycaemia management guidelines, (3) to evaluate the applicability of International Hypoglycaemia Study Group (IHSG) classifications in hospitalised people with diabetes and (4) to identify gaps in care processes amenable to quality improvement (QI) interventions.

methodsWe conducted a retrospective cohort study across 11 UK centres, including all clinically significant hypoglycaemic episodes (IHSG Levels 2 and 3) between October 2023 and December 2024. Data on demographics, precipitants, clinical features, treatment, outcomes and subsequent therapeutic adjustments were analysed.

resultsWe identified 1205 episodes from 674 people (mean age 72 years; 54.5% male; 74.6% with type 2 diabetes; median Charlson Comorbidity Index 6). Common precipitants included intercurrent illness (44.7%), fasting/missed meals (40.7%) and medication dosing errors (16.7%). Inpatient mortality occurred in 2.9% of Level 2 and 15.2% of Level 3 episodes. Episode characteristics varied by sex, diabetes type and centre. The IHSG classification system effectively stratified the risk of adverse outcomes.

conclusionsClinically significant inpatient hypoglycaemia is associated with high mortality and substantial variation in care. The IHSG framework reliably predicts poor outcomes and may serve as a valuable framework for standardised risk stratification and service evaluation. Identification of common, modifiable risk factors highlights opportunities for systematic QI and surveillance.

Indexed as

Diabetes Mellitus, Type 2HospitalizationHypoglycemiaHypoglycemic AgentsAgedAged, 80 and overFemaleHumansInpatientsMaleMiddle AgedRetrospective StudiesUnited KingdomHypoglycemic Agentsdiabetes complicationshypoglycaemiainpatient caremortalityquality improvementrisk factors

Identifiers

PMID42010787
PMCPMC13170989

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.