Severe Hypoglycemia as a Predictor of End-Stage Renal Disease in Type 2 Diabetes: A National Cohort Study

Lee, Yu-Li; Yen, Shih‐Jung; Shin, Shyi–Jang; Huang, Yen-Hsiang; He, Jiun Shiuan; Lin, Kun‐Der

doi:10.3390/ijerph16050681

Cited by 7 publications

(2 citation statements)

References 28 publications

(33 reference statements)

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“…Our results showed that TIR 3.9-10 mmol/L , TAR > 10 mmol/L , and TAR > 13.9 mmol/L are signi cantly associated with the severity of albuminuria, even after adjusting for possible risk factors including HbA1c levels. On the other hand, a recent study demonstrated that severe hypoglycemia is a predictor of worsening renal dysfunction in patients with type 2 diabetes [35]. However, in addition to LBGI, TBR < 3.9 mmol/L , and TBR < 3.0 mmol/L were not associated with the severity of albuminuria in our study.…”

Section: Discussioncontrasting

confidence: 86%

Associations Between Continuous Glucose Monitoring-derived Metrics and Diabetic Retinopathy and Albuminuria in Patients With Type 2 Diabetes

Wakasugi

Mita

Katakami³

et al. 2020

Preprint

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BackgroundPreventing the development and progression of diabetic microvascular complications through optimal blood glucose control remains an important challenge. Whether metrics based on continuous glucose monitoring are useful for the management of diabetic microvascular complications is not entirely clear.MethodsThis is an exploratory analysis of an ongoing prospective, multicenter, 5-year follow-up observational study. Study participants included 999 outpatients with type 2 diabetes who underwent continuous glucose monitoring at baseline. Associations between continuous glucose monitoring-derived metrics and the severity of diabetic retinopathy or albuminuria were investigated using multivariable proportional odds models.ResultsThe overall prevalence of diabetic retinopathy was 22.2%. Multivariate analysis with proportional odds models demonstrated that continuous glucose monitoring-derived metrics related to intra-day and inter-day glucose variability are significantly associated with the severity of diabetic retinopathy, even after adjusting for various possible risk factors. However, significant relationships were not observed after adjusting for HbA1c levels. The prevalence of microalbuminuria and macroalbuminuria were 20.3% and 6.7%, respectively. Similarly, multivariate analysis demonstrated that those metrics are significantly associated with the severity of albuminuria. These relationships remained significant even after further adjusting for HbA1c levels. ConclusionsContinuous glucose monitoring-derived metrics related to intra-day and inter-day glucose variability are significantly associated with the severity of diabetic retinopathy or albuminuria in patients with type 2 diabetes. Thus, evaluating these metrics might possibly be useful for risk assessment of diabetic microvascular complications.

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Section: Discussioncontrasting

confidence: 86%

Associations Between Continuous Glucose Monitoring-derived Metrics and Diabetic Retinopathy and Albuminuria in Patients With Type 2 Diabetes

Wakasugi

Mita

Katakami³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…On the other hand, a recent study demonstrated that severe hypoglycemia is a predictor of worsening renal dysfunction in patients with type 2 diabetes. 35 However, in addition to LBGI, TBR <3.9 mmol/L and TBR <3.0 mmol/L were not associated with the severity of albuminuria in our study. Mild hypoglycemia, low frequency of hypoglycemic events, or both may not be involved in the development of albuminuria.…”

Section: Discussioncontrasting

confidence: 70%

Associations between continuous glucose monitoring-derived metrics and diabetic retinopathy and albuminuria in patients with type 2 diabetes

Wakasugi

Mita

Katakami

et al. 2021

BMJ Open Diab Res Care

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IntroductionPreventing the development and progression of diabetic microvascular complications through optimal blood glucose control remains an important challenge. Whether metrics based on continuous glucose monitoring are useful for the management of diabetic microvascular complications is not entirely clear.Research design and methodsThis is an exploratory analysis of an ongoing prospective, multicenter, 5-year follow-up observational study. Study participants included 999 outpatients with type 2 diabetes who underwent continuous glucose monitoring at baseline. Associations between continuous glucose monitoring-derived metrics and the severity of diabetic retinopathy or albuminuria were investigated using multivariable proportional odds models.ResultsThe overall prevalence of diabetic retinopathy was 22.2%. Multivariate analysis with proportional odds models demonstrated that continuous glucose monitoring-derived metrics related to intraday and interday glucose variability are significantly associated with the severity of diabetic retinopathy, even after adjusting for various possible risk factors. However, significant relationships were not observed after adjusting for hemoglobin A1c (HbA1c) levels. The prevalence of microalbuminuria and macroalbuminuria was 20.3% and 6.7%, respectively. Similarly, multivariate analysis demonstrated that those metrics are significantly associated with the severity of albuminuria. These relationships remained significant even after further adjusting for HbA1c levels.ConclusionsContinuous glucose monitoring-derived metrics related to intraday and interday glucose variability are significantly associated with the severity of diabetic retinopathy or albuminuria in patients with type 2 diabetes. Thus, evaluating these metrics might possibly be useful for risk assessment of diabetic microvascular complications.Trial registration number UMIN000032325.

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Cost-Effectiveness of Glucose-Lowering Therapies as Add-on to Standard Care for People With Type 2 Diabetes in Malaysia

Sim

Chong

Loganadan

et al. 2023

Value in Health Regional Issues

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Severe Hypoglycemia as a Predictor of End-Stage Renal Disease in Type 2 Diabetes: A National Cohort Study

Cited by 7 publications

References 28 publications

Associations Between Continuous Glucose Monitoring-derived Metrics and Diabetic Retinopathy and Albuminuria in Patients With Type 2 Diabetes

Associations Between Continuous Glucose Monitoring-derived Metrics and Diabetic Retinopathy and Albuminuria in Patients With Type 2 Diabetes

Associations between continuous glucose monitoring-derived metrics and diabetic retinopathy and albuminuria in patients with type 2 diabetes

Cost-Effectiveness of Glucose-Lowering Therapies as Add-on to Standard Care for People With Type 2 Diabetes in Malaysia

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