Aims/Introduction: This study aimed to investigate a nutritional index score and activities of daily living (ADLs) in diabetes patients with severe hypoglycemia.

Materials and Methods: Fifty-four diabetes patients who were admitted to a regional hospital for severe hypoglycemia were retrospectively enrolled in the present study. Nutrition-related risk was assessed using the Geriatric Nutritional Risk Index (GNRI). ADLs were assessed using the Barthel Index (BI) at discharge. Intergroup comparisons of clinical characteristics were performed by type of diabetes, age, and GNRI class.

Results: Eight, 44, and two patients had type 1, type 2, and pancreatic diabetes, respectively. Compared with patients with type 1 diabetes, those with type 2 diabetes had a significantly higher age (P < 0.01) and significantly lower GNRI and BI scores (both P < 0.05). GNRI scores were low/moderate/high-risk for one (12.5%) patient with type 1 diabetes and 42 (95.5%) patients with type 2 diabetes. Of type 2 diabetes patients with severe hypoglycemia, 39.5% had a BI score ≤ 70 at discharge, and 88.2% of those were patients aged 65 years or older. In patients with type 2 diabetes, the odds of a BI score ≤ 70 at discharge were significantly higher if inappropriate diet or sick day management preceded hypoglycemia, with an adjusted odds ratio of 10.4 (95% confidence interval: 2.1–51.7, P = 0.004).

Conclusions: Patients with type 2 diabetes and severe hypoglycemia are at nutritional risk, according to GNRI scores. Nutritional assessment using the GNRI may prevent severe hypoglycemia and impairment of ADLs.