Incidence of and risk factors for severe hypoglycaemia in treated type 2 diabetes mellitus patients in the UK – a nested case–control analysis. Issue 9 (19th March 2014)

• Record Type: Journal Article
• Authors: Bruderer, S. G.; Bodmer, M.; Jick, S. S.; Bader, G.; Schlienger, R. G.; Meier, C. R.
• Is Part Of: Diabetes, obesity & metabolism. Volume 16:Issue 9(2014:Sep.)
• Page Start: 801
• Page End: 811
• Publication Date: 2014-03-19
• Subjects: Diabetes -- Periodicals; Obesity -- Periodicals; Metabolism -- Disorders -- Periodicals; Clinical pharmacology -- Periodicals; 616.462
• DOI: 10.1111/dom.12282
• Languages: English
• ISSNs: 1462-8902

Abstract

<abstract abstract-type="main" id="dom12282-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="dom12282-sec-0001" sec-type="section"> <title>Aims</title> <p id="dom12282-para-0001">To assess incidence rates (IRs) of and identify risk factors for incident severe hypoglycaemia in patients with type 2 diabetes newly treated with antidiabetic drugs.</p> </sec> <sec id="dom12282-sec-0002" sec-type="section"> <title>Methods</title> <p id="dom12282-para-0002">Using the UK‐based General Practice Research Database, we performed a retrospective cohort study between 1994 and 2011 and a nested case–control analysis. Ten controls from the population at risk were matched to each case with a recorded severe hypoglycaemia during follow‐up on general practice, years of history in the database and calendar time. Using multivariate conditional logistic regression analyses, we adjusted for potential confounders.</p> </sec> <sec id="dom12282-sec-0003" sec-type="section"> <title>Results</title> <p id="dom12282-para-0003">Of 130 761 patients with newly treated type 2 diabetes (mean age 61.7 ± 13.0 years), 690 (0.5%) had an incident episode of severe hypoglycaemia recorded [estimated IR 11.97 (95% confidence interval, CI, 11.11–12.90) per 10 000 person‐years (PYs)]. The IR was markedly higher in insulin users [49.64 (95% CI, 44.08–55.89) per 10 000 PYs] than in patients not using insulin [8.03 (95% CI, 7.30–8.84) per 10 000 PYs]. Based on results of the nested case–control analysis increasing age [≥75 vs. 20–59 years; adjusted odds ratio (OR), 2.27; 95% CI, 1.65–3.12], cognitive impairment/dementia (adjusted OR, 2.00; 95% CI, 1.37–2.91), renal failure (adjusted OR, 1.34; 95% CI, 1.04–1.71), current use of sulphonylureas (adjusted OR, 4.45; 95% CI, 3.53–5.60) and current insulin use (adjusted OR, 11.83; 95% CI, 9.00–15.54) were all associated with an increased risk of severe hypoglycaemia.</p> </sec> <sec id="dom12282-sec-0004" sec-type="section"> <title>Conclusions</title> <p id="dom12282-para-0004">Severe hypoglycaemia was recorded in 12 cases per 10 000 PYs. Risk factors for severe hypoglycaemia included increasing age, renal failure, cognitive impairment/dementia, and current use of insulin or sulphonylureas.</p> </sec> </abstract>