OBJECTIVES: We aim to characterize and measure the prevalence of ambulatory Type 2 Diabetes Mellitus (T2DM) patients with mild to moderate hypoglycemic events and to explore potential factors associated with these episodes.

METHODS: HIPOS-PHARMA was a nationwide observational, cross-sectional, multicenter study performed in community pharmacies of Portugal, which surveyed T2DM patients under treatment for at least 3 months (4April-20May2016). A structured questionnaire was administered by the pharmacist (socio-demographic and anthropometric data, T2DM related data, antihyperglycemic agents [AHA], other clinical information and previous experience with hypoglycemic episodes). Multivariate logistic regression was used to explore factors that may contribute to mild to moderate hypoglycemic episodes.

RESULTS: A total of 233 pharmacies recruited 1890 patients (males: 50.6%) with a mean age of 67.1 (SD=10.0) years. On average, participants reported to have diabetes for 11.8 (SD=9.3) years. 86.9% had at least one chronic illness or complication of diabetes and 76.8% were usually followed-up in the primary care setting. 58% were on monotherapy or combination of AHA excluding a secretagogue or insulin. The overall prevalence of mild to moderate hypoglycemic episodes in the 3 months prior to recruitment was 17.8% (95%CI:16.1%-19.6%). Results suggested that men and patients having any AHA therapy excluding secretagogue or insulin were less likely to have mild to moderate hypoglycemic episodes (p<0.05). Patients with BMI≥30kg/m, practicing regular physical exercise, employed, with diabetes for ≥10 years, with eye diseases (cataract), disorders of the kidney (nephropathy/kidney failure) and hepatic failure were more likely to suffer these episodes (p<0.05).

CONCLUSIONS: Mild to moderate hypoglycemic episodes were commonly reported in this first Portuguese nationwide study. Findings suggested that several factors may contribute to the occurrence of these events, namely the type of AHA therapy, duration of the disease and due complications. In clinical practice, T2DM management should take in consideration such factors potentially associated with hypoglycemic episodes