MON-620 Ademolus Hypoglycemic Index

This article proposes ADEMOLUS HYPOGLYCEMIC INDEX (AHI) which is a mathematical representation of hypoglycemic episode (HE) in a patient with recurrent hypoglycemia over a consecutive three months period. It also apply it to clinical practice using diabetic patients in order to demonstrate and emphasize its relevance in present day medical practice worldwide. This is a retrospective study of 65 HE occurring in 6 randomly selected diabetes mellitus patients from 86 case files studied who had attended the endocrinology unit. The data was analyzed by using Ademolus Classification of hypoglycemia (ACH) and the 2018 ADA/EASD Classification of hypoglycemia to define hypoglycemia. AHI was calculated from the HE using the proposed mathematical formula. SPSS version 23 was used for data analysis. All six patients had a series of hypoglycemic episodes occurring in three consecutive months. Patient 1 had an AHI of 0.53 using both ACH and 2018 ADA/EASD classification.By using the Pearson correlation statistics, AHI using ACH correlated well with AHI using 2018 ADA/EASD classification of hypoglycemia with a value of 0.993.Similarly the findings of AHI derived using ACH is significant with values derived using ADA/EASD 2018 classification of hypoglycemia with a p-value of 0.000 (correlation is significant at values of 0.01). One of the clinical implication of AHI is that the risk of developing reversible or irreversible neurological damage can be reduced clinically as patient with mild to moderate form of chronic hypoglycemia yet to develop irreversible neurological damage or neurological sequelae can be prevented early enough from progressing since a reduced AHI value out of a series will be a pointer towards progression to neurological damage if it has not occurred! In patient 1 her AHI was not in the severe range. In patient 3, in the last quarter of 2016, her AHI was 0.60, in the first quarter of 2017, her AHI was zero, then between June, July and August 2017 her AHI was 0.64. At this juncture in this patient management, it will be good to evaluate the etiological factors in this chronic kidney disease diabetic patient who once again has started having recurrent hypoglycemia as it was some 6 months earlier. Patient 6 had two consecutive reading of AHI for two consecutive quarters of a year.The result reveals that she is chronically deteriorating gradually and tending towards more severity in her development of HE as her AHI fell from 0.52 in the preceding quarter to 0.46., this connotes worsening chronic hypoglycemic state over time and a poorer prognosis. The lower the AHI, the poorer the prognosis.AHI is relevant for monitoring of chronic or long term recurrent HE in susceptible individuals whether diabetic or not. References: 1. Fonseca VA, Kirkman MS, Darsow T, Ratner RE (2012) The American Diabetes Association Diabetes Research Perspective. Diabetes Care 35(6): 1380–1387.