Risk Factors for Nocturnal Hypoglycemia in Insulin-treated Patients With Type 2 Diabetes: A Secondary Analysis of Observational Data Derived From an Integrated Clinical Trial Database

Bae, Jay; Duan, Ran; Fu, Haoda; Hoogwerf, Byron J.

doi:10.1016/j.clinthera.2017.07.037

Cited by 14 publications

(8 citation statements)

References 19 publications

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“…In the present study, we found that the duration of nocturnal hypoglycemia was longer than that of daytime hypoglycemia, and became longer as the HbA 1c level decreased. A meta-analysis in insulin-treated patients with type 2 diabetes also showed that the incidence of nocturnal hypoglycemia was inversely correlated with HbA 1c level 21 . The 24-h glucose profiles of patients in the present study showed that glucose levels were lowest in the early hours of the morning irrespective of HbA 1c level.…”

Section: Discussionmentioning

confidence: 96%

“…We found that diabetes duration, but not age, was directly related to the duration of hypoglycemia in patients treated with sulfonylureas. The duration of diabetes and age have previously been shown to be associated with the incidence of hypoglycemia in patients with type 2 diabetes in other treatment settings [21][22][23] . Furthermore, we found that the dose of sulfonylureas was associated with the duration of hypoglycemia.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between glycated hemoglobin level and duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas: A multicenter cross‐sectional study

Matsuoka

Hirota

Takeda

et al. 2019

J of Diabetes Invest

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Aims/Introduction Sulfonylurea‐related hypoglycemia increases the risk of cardiovascular sequela, such as cardiac arrhythmia. This study aimed to clarify the relationship between the level of glycated hemoglobin (HbA1c) and the duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas. Materials and Methods Glucose levels in the enrolled patients (n = 300) were investigated with a professional continuous glucose monitoring device in the outpatient setting at six diabetes centers in Japan. Results A total of 269 participants completed the study. The duration of hypoglycemia with glucose values of <54 mg/dL was significantly longer in patients with an HbA1c level of ≤6.4% than in those with an HbA1c level of ≥8.0%, and that of hypoglycemia with glucose values of <70 mg/dL was significantly longer in patients with an HbA1c level of ≤6.4%, 6.5–6.9% or 7.0–7.4% than in those with an HbA1c level of ≥8.0%. Patients with an HbA1c level of ≤6.4% were exposed to glucose values of <70 mg/dL for >10% of the time in daily life (6.8 ± 5.6 min/h). The duration of hypoglycemia with glucose values of <70 mg/dL was longer at night than during the daytime, and the nadir of glucose values occurred between 03.00 and 05.00 hours irrespective of HbA1c level. The duration of hypoglycemia was associated with the duration of diabetes and sulfonylurea dose. Conclusions The duration of hypoglycemia was inversely correlated with HbA1c level and was longer during the night‐time than daytime in type 2 diabetes patients treated with sulfonylureas.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Relationship between glycated hemoglobin level and duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas: A multicenter cross‐sectional study

Matsuoka

Hirota

Takeda

et al. 2019

J of Diabetes Invest

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“…In Taiwan's nationwide population‐based study, symptomatic hypoglycemia was found to be strongly associated with major cardiovascular events that increased hospitalization and all‐cause mortality. Nocturnal hypoglycemia is likely to be underreported, because patients might not awaken or recognize the symptoms during sleep.…”

Section: Challenges With Basal Insulin Therapy In Asiamentioning

confidence: 99%

Basal insulin therapy: Unmet medical needs in Asia and the new insulin glargine in diabetes treatment

Tien

Hung

Chen

et al. 2019

J of Diabetes Invest

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Diabetes remains a global epidemic and a tremendous health challenge, especially in the Asian population. Dramatic increases in the prevalence of diabetes across different countries or areas in Asia have been reported in recent epidemiological studies. Although clinical guidelines have strengthened appropriate antihyperglycemic medications and lifestyle modifications for optimal diabetes management, inadequate glycemic control still occurs in many patients with an increased risk of developing microvascular and macrovascular complications. Insulin administration is the main therapy for diabetes in response to the inability to secrete insulin, and is recommended in current guidelines to treat patients with type 2 diabetes after failure of oral antidiabetic drugs. Clinical studies have shown that long‐acting insulin analogs improve basal glycemic control with reduced risk of hypoglycemia. In the present review, we discuss previous challenges with basal insulin therapy in Asia, the pharmacological development of insulin analogs to overcome the unmet medical needs and recent clinical studies of the new ultra‐long‐acting insulin analog, insulin glargine U300. Furthermore, relevant findings of current real‐world evidence are also included for the comparison of the efficacy and safety of different insulin formulations. Based on the accumulating evidence showing a low incidence of hypoglycemia and technical benefits of dose titration, treatment with glargine U300 can be a promising strategy for Asian diabetes patients to achieve glycemic targets with favorable safety.

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“…В исследованиях было пока-зано повышение риска гипогликемий у пациентов при сочетании инсулинотерапии с препаратами сульфонил-мочевины, с увеличением длительности диабета и раз-витием диабетической нефропатии, с длительностью инсулинотерапии, с возрастом пациентов [6,11,12]. Для таких пациентов необходимо приложение дополнитель-ных усилий для выявления риска гипогликемий и соот-ветствующей коррекции терапии.…”

Section: эндокринологияunclassified

Hypoglycemia after initiating insulin therapy based on the results of structured self-control and monitoring of blood glucose

Петров¹,

Стронгин²

2018

Med. sov.

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Hypoglycemia detection in T2DM patients is an important issue which is usually accomplished with self-monitoring of blood glucose (SMBG). Optimal schedule of testing and diagnostic threshold are important for effective SMBG. Aims of study: To evaluate hypoglycemia frequency by SMBG using structured AccuChek 360 View protocol and glucose monitoring and increase SMBG efficacy in the detection of hypoglycemia. Study design: 16 T2DM patients after initiation of insulin treatment were included. Each patient had 3 days of glucose monitoring together with SMBG 7 times a day after hospital discharge and 3 months later. Results: Hypoglycemia was detected in 38% of monitoring periods; this patients had higher glucose variability and lower average glucose. SMBG detected hypoglycemia in 16% of periods. 6 out of 7 unrecognized hypoglycemias were during night. This 6 cases were characterized by minimal daytime glucose levels by SMBG below 5 mmol/l. ROC-analysis demonstrated minimal glucose level during daytime of 4.8 mmol/l to have 92% sensitivity and 74% specificity for detection of any hypoglycemia by glucose monitoring. Conclusion: Structured Accu-Chek 360 View SMBG can reliably detect daytime hypoglycemia but regular nighttime testing is recommended in all T2DM patients using insulin for detection of nighttime hypoglycemia. Minimal glucose levels below 4.8-5 mmol/l during daytime corresponds with high hypoglycemia risk.

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Risk Factors for Nocturnal Hypoglycemia in Insulin-treated Patients With Type 2 Diabetes: A Secondary Analysis of Observational Data Derived From an Integrated Clinical Trial Database

Cited by 14 publications

References 19 publications

Relationship between glycated hemoglobin level and duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas: A multicenter cross‐sectional study

Relationship between glycated hemoglobin level and duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas: A multicenter cross‐sectional study

Basal insulin therapy: Unmet medical needs in Asia and the new insulin glargine in diabetes treatment

Hypoglycemia after initiating insulin therapy based on the results of structured self-control and monitoring of blood glucose

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