Research reveals which diabetics are more likely to suffer from severe hypos

by Barbara Hewitt on December 29, 2015

Severe hypoglycaemia is more likely among diabetics who are older and have other complications such as chronic kidney disease, heart problems and depression, new research has found.

The analysis of electronic health records of around a million adults with diabetes in the United States set out to find out if certain group of people were more likely to see hypos than others.

Senior-CitizensIt found that rates of severe hypoglycaemia were particularly high among older patients and those with chronic kidney disease, congestive heart failure, cardiovascular disease, depression, and higher HbA1c levels.

Severe hypoglycaemia was also more common among patients taking insulin, insulin secretagogues, and beta-blockers, according to the research from the University of Wisconsin School of Medicine and Public Health.

And the detail from the research reveals that rates of severe hypoglycaemia required medical intervention of 1.4 to 1.6 per 100 person years.

The research indicates that clinicians may underappreciate the risk of hypoglycaemia among people with type 2 diabetes and the impact it has on people’s lives and says that strategies that reduce the risk of hypoglycaemia in high risk patients are needed.

“The data can inform the development of clinical management strategies to more effectively reduce the occurrence of severe hypoglycaemia in community treated patients,” said Dr Ram Pathak, an endocrinologist at the university.

The database used doesn’t distinguish between type 1 and type 2 diabetes, but around 95% of those used for the analysis had type 2 diabetes while the prevalence of comorbidities ranged from 4.9% with congestive heart failure to 18.7% for cardiovascular disease.

Details from the research show that annual rates of severe hypoglycaemia ranged from 1.59 per 100 person years in 2006 to 1.37/100 person years in 2010, with no significant trend by year and no difference by sex.

Severe hypoglycaemia was most common in both the younger and older age groups, ranging from 1.06 to 1.35/100 person years among those aged 20 to 44 and from 2.34 to 2.90/100 person years among those aged 75 and older.

Rates in the youngest age group of 20 to 44 were higher than those among the 45 to 64 year olds, which the research says probably reflects a higher prevalence of type 1 diabetes in this younger group.

Individuals with chronic kidney disease, congestive heart failure, and/or cardiovascular disease had between four and eight times greater rates of severe hypoglycaemia than did those with diabetes but without those comorbidities.

In addition, patients with depression at study entry had an approximately 50% greater risk for severe hypoglycaemia compared with those who were not depressed. Those with two or more episodes of severe hypoglycaemia per year tended to have more comorbidities than did those with one or fewer episodes of severe hypoglycaemia.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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