Incidence rate and patient characteristics of severe hypoglycemia in treated type 2 diabetes mellitus patients in Japan: Retrospective Diagnosis Procedure Combination database analysis

Ikeda, Yuika; Kubo, Takekazu; Oda, Eri; Abe, Machiko; Tokita, Shigeru

doi:10.1111/jdi.12778

Cited by 28 publications

(24 citation statements)

References 40 publications

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“…There was a significant difference in the hypoglycemia episodes, as con irmed by the student t-test (4.06368) at a p value = 0.000147. These results are also aligned with previous studies like a retrospective study conducted in Japan, which indicated multiple factors like age, cognitive decline, combinational therapy with of Insulin and Sulphonylureas have been cited as risk factors for severe hypoglycemia (Ikeda et al, 2018).…”

Section: Higher Cognitive Derangement In Oha and Insulin Combinationasupporting

confidence: 90%

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Combined Treatment with Oral Hypoglycemic Agents and Insulin in Longer Run May Lead to Cognitive Derangement Secondary to Hypoglycemia

Gupta

Singh

2020

ijrps

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To determine the risk associated with combined therapy of oral hypoglycemic agents and insulin in the development of cognitive decline secondary to hypoglycemia. The study comprised of two arms, in arm 1 (n=30) diabetic patients on OHA and insulin combined therapy were observed for cognitive derangement based on Mini Cog score (Pearson’s correlation r was calculated between the two)and the patients were also ruled out for hypoglycemia episodes. Similarly, in arm 2(n=30), only OHA therapy patients were evaluated on the same parameters using Pearson’s correlation. Mean Mini Cog scores were found to be 1.79 in patients on combinational therapy of OHA and insulin. In the case of patients only on OHA for diabetes control mean Mini Cog, the score was 2.0. Pearson’s coefficient r 1 between OHA plus insulin duration of therapy in years with Mini Cog score was -0.5831 at a statistically significant p value of 0.0007. While on the other hand, patients only on OHA therapy (in years)were not significantly correlated with Mini Cog scores.(r 2= - 0.0149 ; p value =0.93771).In the arm 1 (OHA + Insulin(n=30)), the average number of hypoglycemia episodes were found to be 2.633 as compared to the OHA only group in which mean hypoglycemia episodes were 0.866. There was a significant difference in the hypoglycemia episodes, as confirmed by the student t-test (4.06368) at a p value = 0.000147. Based on the study findings, combined Treatment with Oral Hypoglycemic agents and insulin in longer run may lead to cognitive derangement secondary to hypoglycemia.*Significance level <0.01, Negative correlations are indicative of lower the values of battery scores higher would be cognitive derangement.

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Section: Higher Cognitive Derangement In Oha and Insulin Combinationasupporting

confidence: 90%

“…In a retrospective study conducted in Japan, multiple factors like age, cognitive decline, combinational therapy with of Insulin and sulphonylureas have been cited as risk factors for severe hypoglycemia. (Ikeda et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Combined Treatment with Oral Hypoglycemic Agents and Insulin in Longer Run May Lead to Cognitive Derangement Secondary to Hypoglycemia

Gupta

Singh

2020

ijrps

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“…40 Microvascular complications cluster within individuals with type 2 diabetes because of shared pathophysiology 41 and have all been associated with severe hypoglycaemia in large population-based studies of type 2 diabetes. 42 Despite strong bivariate associations between both peripheral sensory neuropathy and retinopathy and incident severe hypoglycaemia in the present study, neither was an independent risk factor in multivariable models. This may have reflected the availability of plasma NT-proBNP concentrations in the FDS2 but not the FDS1.…”

Section: Discussioncontrasting

confidence: 69%

Temporal changes in the incidence and predictors of severe hypoglycaemia in type 2 diabetes: The Fremantle Diabetes Study

Davis

Bruce

Finn

et al. 2018

Diabetes Obesity Metabolism

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Aim To determine the incidence of severe hypoglycaemia and its predictors in community‐based patients with type 2 diabetes studied between 2008 and 2013 compared with those in a cohort of patients with type 2 diabetes from the same geographical area assessed a decade earlier. Methods We studied 1551 participants (mean age 65.7 years, 51.9% men) with type 2 diabetes from the longitudinal observational Fremantle Diabetes Study Phase II (FDS2). Severe hypoglycaemia was ascertained as that requiring ambulance attendance, emergency department services and/or hospitalization. Cox proportional hazards modelling was used to determine predictors of a first episode of severe hypoglycaemia, and negative binomial regression was used to identify predictors of frequency. Results Sixty‐three participants (4.1%) experienced 83 episodes, representing an incidence of 1.34/100 participant‐years (95% confidence interval [CI] 1.08 to 1.67; vs 1.67/100 participant‐years [95% CI 1.31‐2.13] in the Fremantle Diabetes Study Phase I [FDS1]; P = 0.18). Those experiencing severe hypoglycaemia experienced one to four episodes in both cohorts. The independent predictors of incident severe hypoglycaemia in the FDS2 were: older age; higher educational attainment; alcohol consumption; current smoking; sulphonylurea/insulin treatment; prior severe hypoglycaemia; renal impairment; and plasma N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP). The same variables except smoking were associated with frequency of severe hypoglycaemia. Most of these risk factors paralleled those in the FDS1, but current smoking and plasma NT‐proBNP were novel. Conclusions The incidence and frequency of severe hypoglycaemia did not change between the Fremantle Diabetes Study phases but novel risk factors, including plasma NT‐proBNP, were observed in the FDS2.

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“…The current study shows that diabetic complications were a strong predictor for hypoglycemia (OR, 2.74; 95% CI, 1.70 to 4.42). It is well-established from different published studies that the micro and macro complications of diabetes, in addition to infection, are considered predisposing variables for severe hypoglycemia [20,25]. In this study, patients with diabetic foot were three times more likely to have hypoglycemia (OR, 3.70; 95% CI, 1.60 to 8.54).…”

Section: Discussionmentioning

confidence: 64%

Hypoglycemic Risk Factors Among Hospitalized Patients with Type 2 Diabetes Mellitus at King Abdulaziz Medical City, Jeddah

Alghamdi

Alghubayshi

Alshamrani

et al. 2020

Cureus

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Background Hypoglycemia is a pathological condition in which the serum glucose level measures less than 3.0 mmol/L. It is a well-known complication in patients with diabetes mellitus. Age, body weight, gender, insulin usage, nutritional therapy, body mass index (BMI), the presence of diabetes complications, intensive care unit admission, and infection were reported as possible risk factors that may increase the risk of hypoglycemia. Therefore, this study aimed to analyze predisposing factors for hypoglycemia among hospitalized patients with type 2 diabetes in King Abdulaziz Medical City. Method This is a retrospective, case-control study design. The study included 326 hospitalized patients with type 2 diabetes; 152 experienced hypoglycemia (blood glucose <3.9) at least once during hospitalization and have been compared to 174 in the non-hypoglycemic group (blood glucose ≥3.9). Data were extracted from their electronic medical records (EMRs). Results This study reported that patients with lower BMI (28.80 ± 7 versus 31.20 ± 12.93) experienced hypoglycemia (P-value 0.044). Those hospitalized with infections or had acquired infections or required intensive care unit (ICU) admission during hospitalization had a higher risk to develop hypoglycemia (P-value 0.005, 0.003, and <0.001, respectively). Moreover, the use of multiple doses of insulin therapy or basal-plus insulin therapy was associated with a higher risk of hypoglycemia (P-value 0.012 and 0.028, respectively). Those on supplemental insulin were less likely to develop hypoglycemia (P-value <0.001). Patients on oral feeding had a lower chance of having a hypoglycemic attack (P-value 0.002) while those on tube feeding had double the odds (OR=2.37). Conclusions Infection, intensive care unit admission, lower body mass index, insulin regimen and nutritional therapy (enteral feeding and nothing-per-mouth (NPO)) were correlated with an elevated risk of having hypoglycemia in hospitalized patients with type 2 diabetes mellitus.

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Incidence rate and patient characteristics of severe hypoglycemia in treated type 2 diabetes mellitus patients in Japan: Retrospective Diagnosis Procedure Combination database analysis

Cited by 28 publications

References 40 publications

Combined Treatment with Oral Hypoglycemic Agents and Insulin in Longer Run May Lead to Cognitive Derangement Secondary to Hypoglycemia

Combined Treatment with Oral Hypoglycemic Agents and Insulin in Longer Run May Lead to Cognitive Derangement Secondary to Hypoglycemia

Temporal changes in the incidence and predictors of severe hypoglycaemia in type 2 diabetes: The Fremantle Diabetes Study

Hypoglycemic Risk Factors Among Hospitalized Patients with Type 2 Diabetes Mellitus at King Abdulaziz Medical City, Jeddah

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