Hypoglycaemia in patients with Alcohol-Related Disorders (ARD): unexplored features from the experience of an Emergency department

Background So far, the majority of studies have focused on the features of diabetes-related hypoglycaemia. Nonetheless, hypoglycaemia is often present in patients with alcohol-related disorders (ARD), and may determine the need of an emergency treatment. Little is known, however, on the clinical characteristics and the outcomes of patients with alcohol-related hypoglycaemia in Emergency Department. Methods A retrospective study on the accesses in the Emergency Department of a large teaching hospital in Rome was conducted to ascertain patients presenting with hypoglycaemia. The observation period was from January 2012 to December 2013 (24 months). A total of 441 patients had hypoglycaemia (plasma glucose <70 mg/dl) in their first laboratory measurement. 51 of them were had a diagnosis of Alcohol Related Disorders and formed the study group. Results Anthropometric data, blood chemistry, treatment in A&E and the outcome of the ARD patients were compared with the data of the other 390 patients with hypoglycaemia not related to alcoholism. The ARD group was composed of almost all men (42/51), with a mean age lower than the other group (45.24±13 vs. 57.08 ±22.8, p<0.001). All ARD subjects had normal renal function, lower prevalence of diabetes mellitus, but had signs of liver damage from alcohol. We also conducted a systematic review of the literature, which showed specific clinical characteristics of the patients with ADR, such as younger age, male sex, and milder hypoglycaemia. Conclusions Our study adds new knowledge on unexplored and unknown aspects of alcohol-related hypoglycaemia, defining a patient phenotype in which alcohol-related disorders should be sought with a targeted medical history, in order to activate a specific diagnostic and therapeutic pathway