Severe Hypoglycemia as a Predictor of End-Stage Renal Disease in Type 2 Diabetes: A National Cohort Study

Aims: This study investigated whether there is a link between severe hypoglycemia and progression into end-stage renal disease (ESRD) in patients with type 2 diabetes. Methods: Tapping into Taiwan’s Health Insurance Research Database, we identified all type 2 diabetes patients between 1996 and 2013 and identified those diagnosed with a severe hypoglycemia episode during an emergency department visit and those who were not. Controls were then matched 1:1 for age, sex, index year, and medication. Results: We identified 468,421 type 2 diabetes patients diagnosed as having severe hypoglycemia in an emergency department visit. Compared with controls, these patients with SH had a higher risk of all-cause mortality (Hazard Ratio (HR), 1.76; 95% confidence interval, 1.61–1.94) and progressed into ESRD within a shorter period of time. Results were similar after controlling for competing risk. Conclusion: Severe hypoglycemia is significantly associated with worsening renal dysfunction in patients with type 2 diabetes and hastened progression into ESRD.

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Hepatic and cardiovascular safety of acarbose among type 2 diabetes patients with end-stage renal disease: A nationwide population-based longitudinal study

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2020.108489 ◽

2020 ◽

pp. 108489

Author(s):

Wei-Hung Lin ◽

Chen-Yi Yang ◽

Shihchen Kuo ◽

Te-Hui Kuo ◽

Jun-Neng Roan ◽

...

Keyword(s):

Type 2 Diabetes ◽

Longitudinal Study ◽

Renal Disease ◽

End Stage Renal Disease ◽

Population Based ◽

Cardiovascular Safety ◽

Stage Renal Disease ◽

End Stage ◽

Diabetes Patients

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Severe hypoglycemia and the risk of end stage renal disease in type 2 diabetes

Scientific Reports ◽

10.1038/s41598-021-82838-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jae-Seung Yun ◽

Yong-Moon Park ◽

Kyungdo Han ◽

Hyung-Wook Kim ◽

Seon-Ah Cha ◽

...

Keyword(s):

Type 2 Diabetes ◽

Renal Disease ◽

End Stage Renal Disease ◽

Severe Hypoglycemia ◽

National Health Insurance System ◽

Increased Risk ◽

Baseline Evaluation ◽

Stage Renal Disease ◽

End Stage

AbstractWe investigated the association between the incidence of severe hypoglycemia and the risk of end-stage renal disease (ESRD) in patients with type 2 diabetes. Baseline and follow-up data for 988,333 participants with type 2 diabetes were retrieved from the National Health Insurance System database. The number of severe hypoglycemia episodes experienced from 2007 to 2009 was determined. The primary outcome was the development of ESRD after the baseline evaluation. Participants were followed from the baseline until death or December 31, 2016, during this period 14,545 participants (1.5%) developed ESRD. In the crude model, compared with those who experienced no severe hypoglycemia, the hazard ratios (95% confidential intervals) for developing ESRD were 4.96 (4.57–5.39), 6.84 (5.62–8.32), and 9.51 (7.14–12.66) in participants who experienced one, two, and three or more episodes of severe hypoglycemia, respectively. Further adjustment for various confounding factors attenuated the association between severe hypoglycemia and ESRD; the significance of the association between severe hypoglycemia and ESRD was maintained. Having three or more severe hypoglycemia episodes was associated with a nearly two-fold increased risk of developing ESRD. Prior episodes of severe hypoglycemia were associated with an increased risk of ESRD among Korean adults with type 2 diabetes.

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