Abstract
Background: The goals of the present study were to quantify incidence rate of hypoglycemia, in-vestigate risk factors for hypoglycemia in patients with type 2 diabetes mellitus (T2DM) and suggest preventive measures.
Methods: This study was a retrospective cohort, multicenter, non-interventional study of hypogly-cemic events, used previously acquired data from 10,359 patients with T2DM, who were treated between March 2015 and March 2018. Two aspects of our research were investigated: (i) retrospec-tive study to assess the incidence of hypoglycemia during hospitalization; and (ii) to determine the relationship between hypoglycemia and risk factors such as age, HbA1c, complications, duration of DM, insulin and/or SU use, and cognitive impairment.
Results: Overall, 9,993 patients were included in the full analysis set, 376 patients were identified hypoglycemia in the database. Demographic characteristics of patients with T2DM were similar between hypoglycemia and non-hypoglycemia groups, significant differences were not observed between the groups, except for cognitive impairment (p =0.037). The most common cause of hypo-glycemia was drug overdose/misuse (34.2%), irregular diet (21.3%), and excessive physical activity (13.8%). Most of the hypoglycemic episodes occurred before and after lunch (39.4% between 10:00 and 13:00). Retrospective rates (events per patient per month [PPPM]) of overall, severe, and noc-turnal hypoglycemia were 3.83 events PPPM (95% CI 1.90–5.80), 1.17 events PPPM (95% CI 0.78-1.56), and 0.07 events PPPM (95% CI 0.05-0.09). Multivariate model analysis showed that the use of SU (OR=3.162, p = 0.040) and insulin (OR= 2.414, p = 0.017) were associated with hypo-glycemic events. Logistic regression analysis of the variables revealed that significant positive as-sociation of the frequency of overall and severe hypoglycemia with age (beta=0.855, p=0.018; be-ta=1.343, p=0.015) and duration of DM (beta=1.248, p=0.025; beta=0.947, p=0.014).
Conclusions: The present study shows that advanced age, duration of DM, cognitive dysfunction, and insulin and/or SU use are the main causes of hypoglycemia in Chinese patients with T2DM. Education on hypoglycemia, appropriate use of antidiabetic drugs and avoidance of related risk factors are essential for patients with DM.
Incidence rate and patient characteristics of severe hypoglycemia in treated type 2 diabetes mellitus patients in Japan: Retrospective Diagnosis Procedure Combination database analysis
