Antidiabetic pharmacotherapy and anamnestic hypoglycemia in a large cohort of type 2 diabetic patients - an analysis of the DiaRegis registry

Tschöpe, D; Bramlage, Peter; Binz, Christiane; Krekler, Michael; Plate, Tanja; Deeg, Evelin; Gitt, Anselm K.

doi:10.1186/1475-2840-10-66

Cited by 33 publications

(24 citation statements)

References 20 publications

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“…Because hypoglycemia was assessed similarly in all three studies, we suspect that the higher rates of hypoglycemia in the DISTANCE Study cohort reflect the true risk in an ethnically diverse, real-world diabetes cohort, relative to more selective trial cohorts. Population-based studies in Finnish 40 and German 41 diabetes patients reported similarly high population rates of hypoglycemia. Glycemic targets based on data from highly selected populations with low rates of hypoglycemia may overestimate net clinical benefit for real-world patients.…”

Section: Discussionmentioning

confidence: 93%

Low Socioeconomic Status is Associated with Increased Risk for Hypoglycemia in Diabetes Patients: The Diabetes Study of Northern California (DISTANCE)

Berkowitz¹,

Karter²,

Lyles³

et al. 2014

hpu

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Background Social risk factors for hypoglycemia are not well understood. Methods Cross-sectional analysis from the DISTANCE study, a multi-language, ethnically-stratified random sample of adults in the Kaiser Permanente Northern California diabetes registry, conducted in 2005-2006 (response rate 62%). Exposures were income and educational attainment; outcome was patient report of severe hypoglycemia. To test the association, we used multivariable logistic regression to adjust for demographic and clinical factors. Results 14,357 patients were included. Reports of severe hypoglycemia were common (11%), and higher in low-income vs. high-income (16% vs. 8.8) and low-education vs. high-education (11.9% vs. 8.9%) groups. In multivariable analysis, incomes of less than $15,000 (OR 1.51 95%CI 1.19-1.91), $15,000-$24,999 (OR 1.57 95%CI 1.27-1.94), and high school or less education (OR 1.42, 95% CI 1.24-1.63) were associated with increased hypoglycemia, similar to insulin use (OR 1.44 95%CI 1.19-1.74). Conclusions Low income and educational attainment are important risk factors for hypoglycemia.

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Section: Discussionmentioning

confidence: 93%

Low Socioeconomic Status is Associated with Increased Risk for Hypoglycemia in Diabetes Patients: The Diabetes Study of Northern California (DISTANCE)

Berkowitz¹,

Karter²,

Lyles³

et al. 2014

hpu

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“…Also regarding age, several studies selected in this review emphasize caution in the use of sulfonylureas in the elderly, because they have greater chances of developing severe hypoglycemia 25 , 27 .…”

Section: Discussionmentioning

confidence: 99%

Risk factors for unstable blood glucose level: integrative review of the risk factors related to the nursing diagnosis

Teixeira¹,

Tsukamoto

Lopes

et al. 2017

Rev. Latino-Am. Enfermagem

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Objective:to identify evidence in the literature on the possible risk factors for the risk of unstable blood glucose diagnosis in individuals with type 2 diabetes mellitus, and to compare them with the risk factors described by NANDA International. Method:an integrative literature review guided by the question: what are the risk factors for unstable blood glucose level in people with type 2 diabetes mellitus? Primary studies were included whose outcomes were variations in glycemic levels, published in English, Portuguese or Spanish, in PubMed or CINAHL between 2010 and 2015. Results:altered levels of glycated hemoglobin, body mass index>31 kg/m2, previous history of hypoglycemia, cognitive deficit/dementia, autonomic cardiovascular neuropathy, comorbidities and weight loss corresponded to risk factors described in NANDA International. Other risk factors identified were: advanced age, black skin color, longer length of diabetes diagnosis, daytime sleepiness, macroalbuminuria, genetic polymorphisms, insulin therapy, use of oral antidiabetics, and use of metoclopramide, inadequate physical activity and low fasting glycemia. Conclusions:risk factors for the diagnosis, risk for unstable blood glucose level, for persons with type 2 diabetes mellitus were identified, and 42% of them corresponded to those of NANDA International. These findings may contribute to the practice of clinical nurses in preventing the deleterious effects of glycemic variation.

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“…Hypoglycemia is observed during acarbose treatment only when it is given in combination with insulinotropic substances or insulin itself. Even then, the risk of hypoglycemia is reduced because of combination with the antihyperinsulinemic agent, acarbose 43–47…”

Section: Significance Of Acarbose Properties For the Patientmentioning

confidence: 99%

Critical evaluation of the role of acarbose in the treatment of diabetes: patient considerations

Rosak¹,

Mertes²

2012

DMSO

178

112

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The alpha-glucosidase inhibitor acarbose has been used for more than 20 years in the management of hyperglycemia. Owing to its unique mode of action in the gastrointestinal tract, its properties are very different from other antidiabetic medications. Patients on long-term treatment to control a chronic disease are not only interested in good treatment efficacy, but are also even more interested in the safety and side effects of their medications. Significant aspects of acarbose predominantly regarding safety and tolerability in the management of type 2 diabetes and prediabetes are reviewed. It is concluded that acarbose is a convenient long-term treatment option, with benefits for both type 2 diabetics and patients in a prediabetic state.

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Antidiabetic pharmacotherapy and anamnestic hypoglycemia in a large cohort of type 2 diabetic patients - an analysis of the DiaRegis registry

Abstract: Background: We aimed to identify predictors of anamnestic hypoglycaemia in type-2 diabetic patients on oral mono-or dual oral combination antidiabetic pharmacotherapy.

Cited by 33 publications

References 20 publications

Low Socioeconomic Status is Associated with Increased Risk for Hypoglycemia in Diabetes Patients: The Diabetes Study of Northern California (DISTANCE)

Low Socioeconomic Status is Associated with Increased Risk for Hypoglycemia in Diabetes Patients: The Diabetes Study of Northern California (DISTANCE)

Risk factors for unstable blood glucose level: integrative review of the risk factors related to the nursing diagnosis

Critical evaluation of the role of acarbose in the treatment of diabetes: patient considerations

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