• Yusron Amin Brawijaya University
  • Ahsan Ahsan
  • Tony Suharsono




infection, antidiabetic therapy, meal intake, hypoglicemia


Hipoglycemia was a kind of acute complication of diabetes mellitus. Some factors was assumed associated with degree of hypoglycemia were infection, antidiabetic therapy, and leak of meal intake. This study was to analyse factors associated with degree of hypoglycemia in emergency department. Design was descriptive explorative with retrospective approach. Sum of respondents was 118 medical records. This study was conducted in medical record room in Blambangan hospital and Genteng Hospital from 5 June 2017 to 16 June 2017. Methods of data collection was purposive sampling. The results showed hypoglycemia was happened in majority of infection, using of unappropriate antidiabetic therapy and leak of meal intake. Infection factors  (p=0,000; r=0,494), using of antidiabetic therapy (p=0,000; r=0,411), and leak of meal intake (p=0,000; r=0,619) had correlation with degree of hypoglycemia. Leak of meal intake factors (p=0,000; wald=27.897) had strongly correlation with degree of hypoglycemia. Health workers especially nurses was encouraged to conduct the intervention due to patient’s self control, so that regulation of meal and antidiabetic therapy could work effectively.


  • American Diabetes Association (ADA). 2015. Diabetes care. The Journal of Clinical and Applied Reseach and Education; 38(1): S38-S39.
  • Asvold, B.O., Sand, T., Hestad, K., and Bjorgaas, M.R. (2010). Cognitive function in type 1 diabetic adults with early exposure to severe hypoglycemia: A 16-year follow-up study. Diabetes Care; 33: 1945-7.
  • Bree, A.J., Puente, E.C., Daphna-Iken, D., and Fisher, S.J. (2009). Diabetes increases brain damage caused by severe hypoglycemia. Am J Physiol Endocrinol Metab; 297: E194-201.
  • Cryer, P. (2007). Hypoglycemia in diabetes: pathophysiology, prevalence and prevention. 2nd ed. Alexandria, VA: American Diabetes Association.
  • Cryer, P. (2012). Hypoglycemia in diabetes: pathophysiology, prevalence and prevention. 2nd ed. Alexandria, VA: American Diabetes Association.
  • Duckworth, W., Abraira, C., Moritz, T., et al. (2009). Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med: 360:129–139.
  • Eren, S.H., Caliskan, M.H., Kilicli, F., Korkmaz, I., Acibucu, F., and Dokmetas, H.S. (2010). Etiologies of patients admitted to emergency department with hypoglycemia. Scientific Research and Essays; 5(12): 1479-1482
  • Gogitidze, J.N., Hedrington, M.S., Briscoe, V.J., et al. (2010). Effects of acute hypoglycemia on inflammatory and pro-atherothrombotic biomarkers in individuals with type 1 diabetes and healthy individuals. Diabetes Care; 33:1529–1535.
  • Guyton, A.C., and Hall, J.E. (2007). Buku Ajar Fisiologi Kedokteran. Edisi 11. Jakarta: EGC.
  • Hulkower, R.D., Pollack, R.M., and Zonszein, J. (2014). Understanding Hypoglycemia in Hospitalized Patients. Diabetes Manage; 4(2): 165-176.
  • Iglesias, P.T.,& Shannon, M.H. (2012). Managing Hypoglycemia in Primary Care. Journal of Family Practice; 61(10):S1-S7
  • Jan, S., T, T., Chen, ., Jerng ,T. 2009. Hypoglycemia associated with bacteremic pneumococcal infections. International Journal of Infectious Diseases; 13:570-576
  • Kalra, S; Mukherjee, J.J; Venkataraman, S; Bantwal, G; Shaikh, S; Saboo, B; Das, A.K; Ramachandran, A. (2013). Review Article: Hypoglycemia: The Neglected Complication. Indian Journal of Endocrinology and Metabolism; 17 (5): 819-834.
  • Marrett, E., Radican, L., Davies, M.J., et al. (2011). Assessment of severity and frequency of selfreported hypoglycemia on quality of life in patients with type 2 diabetes treated with oral antihyperglycemic agents: A survey study. BMC Res Notes, 4:251.
  • Mantovani, A., Grani, G., Chioma, L., Vancieri, G., Giordani, I., Rendina, R., Rinaldi, M.E., and Andreadi, A. (2016). Severe hypoglycemia in patients with known diabetes requiring emergency department care: A report from an Italian multicenter study. Journal of Clinical & Translational Endocrinology; 5: 46–52
  • Nursalam. 2008. Konsep dan Penerapan Metodologi Penelitian Ilmu Keperawatan. Jakarta: Salemba Medika.
  • Philip, E., and Cryer. (2008). The Barrier of Hypoglycemia in Diabetes. Perspective in Diabetes; 57: 3169-3176
  • Philip, E. and Cryer. (2013). Mechanisms of Hypoglycemia- Associated Autonomic Failure in Diabetes. The New England Journal of Medicine; 364(4); 362-372.
  • Salutini, E., Bianchi, C., Santini, M., Dardano, A., Daniele, G., Penno, G., et al. (2015). Prato Access to emergency room for hypoglycaemia in people with diabetes. Diabetes Metab Res Rev; 31(7): 745-751
  • Sommerfield, A.J., Wilkinson, I.B., Webb, D.J., and Frier, B.M. (2007). Vessel wall stiffness in type 1 diabetes and the central hemodynamic effect of acute hypoglycemia. Am J Physiol Endocrinol Metab; 293: e127-9.
  • Shafiee, G., Mohajeri, M., Pajouhi, M., and Larijani, B. (2012). The importance of hypoglycemia in diabetic patients. Journal of Diabetic & Metabolic Disorders; 11(17): 1-7
  • Su, Y., and Liao, C. (2015). Hypoglycemia in Emergency Department. Journal of Acute Disease: 59-62
  • Su, Y.J., Lai, Y.C., and Liao, C.J. (2017). Hazardous factors besides infection in hypoglycemia. Biomedical Report; (6) 4: 480-484.
  • Whitmer, R.A., Karter, A.L., Yaffe, K., Quesenberry, C.P., and Selby, J.V. (2009). Hypoglycemic episode and risk of dementia in older patient with type 2 diabetes mellitus. JAMA; 301: 1565-72.
  • Williams, S.A., Pollack, M.F., and Dibonaventura, M. (2010). Effects of hypoglycemia on health-related quality of life, treatment satisfaction and healthcare resource utilization in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract, 91:363–370.
  • Wright, R.J., and Frier, B.M. (2008). Vascular disease and diabetes: Is hypoglycemia an aggravating factor? Diabetes Metab Res Rev; 24:353-63.