Higher glucose variability in type 1 than in type 2 diabetes patients admitted to the intensive care unit: A retrospective cohort study

Sechterberger, Marjolein K.; Steen, S. C. J. van; Boerboom, Esther M.N.; Voort, Peter H. J. van der; Bosman, Rob J.; Hoekstra, J. B. L.; DeVries, J. Hans

doi:10.1016/j.jcrc.2016.12.021

Cited by 12 publications

(15 citation statements)

References 14 publications

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“…Following assessment of 65 full text articles, 41 were excluded, leaving 24 studies, including HAT, that were eligible for inclusion in the analyses. Ten studies, DIALOG, GAPP2 UK, GAPP2 Canada, COMPASS, DSP China, PANORAMA, JADE, survey of insulin adherence, the single centre study in India, and the ICU study primarily reported hypoglycaemia prevalence in terms of the proportion of participants reporting hypoglycaemia, rather than rates in events per patient‐year (PPY); thus, these studies are reported separately.…”

Section: Resultsmentioning

confidence: 99%

“…The definitions of hypoglycaemia varied widely among studies (Table S2) and only the HAT, DIALOG, survey of self‐reported insulin adherence and HypoAna studies defined hypoglycaemia in accordance with ADA definitions . Documentation was based primarily on symptoms, while a limited number of studies (a self‐reported non‐severe hypoglycaemia study in Europe, a self‐reported non‐severe hypoglycaemia study in Germany, a single‐centre study in Germany, a basal insulin dose‐timing study, an ICU cohort study, the PREDICTIVE and HypoAna studies) required documentation with glucose thresholds defined.…”

Section: Resultsmentioning

confidence: 99%

“…Data from real‐world studies of patients with T1D were available for Europe (a self‐reported non‐severe hypoglycaemic events study in Europe, a self‐reported non‐severe hypoglycaemic events study in Germany, the PREDICTIVE, DIALOG and HypoAna studies, a study by Kristensen et al, the ICU cohort study, the UK Hypoglycaemia study, and the UK self‐reporting study), Japan and Brazil …”

Section: Resultsmentioning

confidence: 99%

“…Real‐world studies of patients with T2D included global studies (GAPP2, A1chieve and SOLVE), European studies (GAPP2 UK, a self‐reported non‐severe hypoglycaemic events study in Europe, a self‐reported non‐severe hypoglycaemic events study in Germany, the PREDICTIVE and DIALOG studies, the UK Hypoglycaemia study, a single‐centre survey in Germany, the UK self‐reporting study, the PANORAMA and ICU cohort studies), Asian/South East Asian studies (Physicians' Routine Evaluation of Safety and Efficacy of NovoMix 30 Therapy [PRESENT], COMPASS, Diabetes Disease Specific Programme [DSP] China, the JADE study, a single‐centre study in India, a basal insulin dose‐timing study in Japan) and one study from North America (GAPP2 Canada).…”

Section: Resultsmentioning

confidence: 99%

“…Data from real-world studies of patients with T1D were available for Europe (a self-reported non-severe hypoglycaemic events study in Europe, 3 a self-reported non-severe hypoglycaemic events study in Germany, 27 the PREDICTIVE, 26 DIALOG 16 and HypoAna studies, 33,34 a study by Kristensen et al, 36 the ICU cohort study, 24 the UK Hypoglycaemia study, 32 and the UK self-reporting study 30 ), Japan 25 and Brazil. 22 Real-world studies of patients with T2D included global studies (GAPP2, 31 A1chieve 29 and SOLVE 37 ), European studies (GAPP2 UK, 17 a self-reported non-severe hypoglycaemic events study in Europe, 3 a self-reported non-severe hypoglycaemic events study in Germany, 27 the PREDICTIVE 26 and DIALOG 16 studies, the UK Hypoglycaemia study, 32 a single-centre survey in Germany, 28 the UK self-reporting study, 30 the PANORAMA 20 and ICU cohort studies 24 19 , the JADE study 21 , a single-centre study in India, 23 a basal insulin dose-timing study in Japan 25 ) and one study from North America (GAPP2 Canada 5 ).…”

Section: Evaluation Of the Hat Study And Comparative Real-world CLImentioning

confidence: 99%

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Comparison of the HAT study, the largest global hypoglycaemia study to date, with similar large real‐world studies

Pedersen‐Bjergaard

Alsifri

Aronson

et al. 2018

Diabetes Obesity Metabolism

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Aims Optimal diabetes care requires clear understanding of the incidence of hypoglycaemia in real‐world clinical practice. Current data on hypoglycaemia are generally limited to those reported from randomised controlled clinical trials. The Hypoglycaemia Assessment Tool (HAT) study, a non‐interventional real‐world study of hypoglycaemia, assessed hypoglycaemia in 27 585 individuals across 24 countries. The present study compared the incidence of hypoglycaemia from the HAT study with other similarly designed, large, real‐world studies. Materials and Methods A literature search of PubMed (1995‐2017) for population‐based studies of insulin‐treated patients with type 1 or type 2 diabetes (T1D, T2D), excluding clinical trials and reviews, identified comparable population‐based studies reporting the incidence of hypoglycaemia. Results The 24 comparative studies, including more than 24 000 participants with T1D and more than 160 000 participants with T2D, varied in design, size, inclusion criteria, definitions of hypoglycaemia and method of recording hypoglycaemia. Reported rates (events per patient‐year [PPY]) of hypoglycaemia were higher in patients with T1D than in those with T2D (overall T1D, 21.8‐73.3 and T2D, 1.3‐37.7; mild/non‐severe T1D, 29.0‐126.7 and T2D, 1.3‐41.5; severe T1D, 0.7‐5.8 and T2D, 0.0‐2.5; nocturnal T1D, 2.6‐11.3 and T2D, 0.38‐9.7) and were similar to the ranges found in the HAT study. Conclusions The HAT data on hypoglycaemia incidence were comparable with those from other real‐world studies and indicate a high incidence of hypoglycaemia among insulin‐treated patients. Differences in rates among studies are mostly explained by differences in patient populations and study methodology. The goal of reducing hypoglycaemia should be a target for continued educational and evidence‐based pharmacological interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Evaluation Of the Hat Study And Comparative Real-world CLImentioning

confidence: 99%

See 3 more Smart Citations

Comparison of the HAT study, the largest global hypoglycaemia study to date, with similar large real‐world studies

Pedersen‐Bjergaard

Alsifri

Aronson

et al. 2018

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

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Glucose variability and mood in adults with diabetes: A systematic review

Muijs

Racca

Brouwer

et al. 2020

Endocrino Diabet & Metabol

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Aims To systematically review the literature regarding the association between glucose variability (GV) and mood in adults with diabetes, appraise the used methods and make suggestions for future research. Methods A systematic review of literature published up to May 2019 was performed. Abstracts and full texts were screened independently in duplicate. Experimental and observational studies reporting the association between GV and mood in adults with type 1 diabetes or type 2 diabetes were evaluated. A descriptive analysis of the extracted data was conducted, along with a quality assessment. Results Out of the 2.316 studies screened, eight studies met our criteria. Studies used a variety of measures and metrics to determine GV and mood. Four studies used continuous glucose monitoring (CGM). An association between GV and mood was found in four studies when correlating either postprandial glucose rate of increase with current mood or multiday GV with mood measured retrospectively. The other four studies did not find any association. Conclusions There is no clear empirical support for a link between GV and mood in adults with type 1 and type 2 diabetes. More rigorous research is warranted using CGM and ecological momentary assessment of mood to assess if and under what conditions an association between GV and mood exists.

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Association between dysglycemia and mortality by diabetes status and risk factors of dysglycemia in critically ill patients: a retrospective study

Guo

Wang

et al. 2021

Acta Diabetol

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Aims Dysglycemia, including the three domains hyperglycemia, hypoglycemia, and increased glycemic variability (GV), is associated with high mortality among critically ill patients. However, this association differs by diabetes status, and reports in this regard are limited. This study aimed to evaluate the associations between the three dysglycemia domains and mortality in critically ill patients by diabetes status and determined the contributing factors for dysglycemia. Methods This retrospective study included 958 critically ill patients (admitted to the ICU) with or without DM. Dysglycemia was defined as abnormality of any of the three dimensions. We evaluated the effects of the three domains of glucose control on mortality using binary logistic regression and then adjusted for confounders. The associations between dysglycemia and other variables were investigated using cumulative logistic regression analysis. Result GV independently and similarly affected mortality in both groups after adjustment for confounders (DM: odds ratio [OR], 1.05; 95% confidence interval [CI]: 1.03-1.08; p <0.001; non-DM: OR, 1.07; 95% CI, 1.03-1.11; p = 0.002). Hypoglycemia was strongly associated with ICU mortality among patients without DM (3.12; 1.76-5.53; p <0.001) and less so among those with DM (1.18; 0.49-2.83; p = 0.72). Hyperglycemia was non-significantly associated with mortality in both groups. However, the effects of dysglycemia seemed cumulative. The factors contributing to dysglycemia included disease severity, insulin treatment, glucocorticoid use, serum albumin level, total parenteral nutrition, duration of diabetes, elevated procalcitonin level, and need for mechanical ventilation and renal replacement therapy. Conclusion The association between the three dimensions of dysglycemia and mortality varied by diabetes status. Dysglycemia in critical patients is associated with excess mortality; however, glucose management in patients should be specific to the patient’s need considering the diabetes status and broader dimensions. The identified factors for dysglycemia could be used for risk assessment in glucose management requirement in critically ill patients, which may improve clinical outcomes.

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Higher glucose variability in type 1 than in type 2 diabetes patients admitted to the intensive care unit: A retrospective cohort study

Cited by 12 publications

References 14 publications

Comparison of the HAT study, the largest global hypoglycaemia study to date, with similar large real‐world studies

Comparison of the HAT study, the largest global hypoglycaemia study to date, with similar large real‐world studies

Glucose variability and mood in adults with diabetes: A systematic review

Association between dysglycemia and mortality by diabetes status and risk factors of dysglycemia in critically ill patients: a retrospective study

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