Incidence and risk factors for severe and symptomatic hypoglycemia in type 1 diabetes. Results of the HYPOS-1 study
Objective Hypoglycemia is common in type 1 diabetes mellitus (T1DM). We aimed to update the incidence of severe and symptomatic hypoglycemia and investigate several correlated factors. Methods In this multicenter, observational retrospective study, the data of 206 T1DM patients from a sample of 2,22...
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creator | Giorda, Carlo B. Ozzello, Alessandro Gentile, Sandro Aglialoro, Alberto Chiambretti, Anna Baccetti, Fabio Gentile, Francesco M. Lucisano, Giuseppe Nicolucci, Antonio Rossi, Maria Chiara |
description | Objective
Hypoglycemia is common in type 1 diabetes mellitus (T1DM). We aimed to update the incidence of severe and symptomatic hypoglycemia and investigate several correlated factors.
Methods
In this multicenter, observational retrospective study, the data of 206 T1DM patients from a sample of 2,229 consecutive patients seen at 18 diabetes clinics were analyzed. Sociodemographic and clinical characteristics, severe hypoglycemia in the past 12 months, and symptomatic hypoglycemia in the past 4 weeks were recorded with a self-report questionnaire and a clinical form during a routine visit. Poisson multivariate models were applied.
Results
A minority of patients accounted for the majority of both severe and symptomatic episodes. The incidence rate (IR) of severe hypoglycemia was 0.49 (0.40–0.60) events/person-years. The incidence rate ratio (IRR) was higher in patients with previous severe hypoglycemia (3.71; 2.28–6.04), neuropathy (4.16; 2.14–8.05), long duration (>20 years, 2.96; 1.60–5.45), and on polypharmacy (1.24; 1.13–1.36), but it was lower when a complication was present. The IR of symptomatic hypoglycemia was 53.3 events/person-years, with an IRR significantly higher among women or patients with better education, or shorter duration or on pumps. The IRR was lower in patients with higher BMI or neuropathy or aged more than 50 years.
Conclusions
Fewer than 20 % of T1DM patients are free from hypoglycemia, with one in six having experienced at least one severe episode in the last year. The distribution is uneven, with a tendency of episodes to cluster in some patients. Severe and symptomatic episodes have different correlates and reflect different conditions. |
doi_str_mv | 10.1007/s00592-015-0713-4 |
format | Article |
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Hypoglycemia is common in type 1 diabetes mellitus (T1DM). We aimed to update the incidence of severe and symptomatic hypoglycemia and investigate several correlated factors.
Methods
In this multicenter, observational retrospective study, the data of 206 T1DM patients from a sample of 2,229 consecutive patients seen at 18 diabetes clinics were analyzed. Sociodemographic and clinical characteristics, severe hypoglycemia in the past 12 months, and symptomatic hypoglycemia in the past 4 weeks were recorded with a self-report questionnaire and a clinical form during a routine visit. Poisson multivariate models were applied.
Results
A minority of patients accounted for the majority of both severe and symptomatic episodes. The incidence rate (IR) of severe hypoglycemia was 0.49 (0.40–0.60) events/person-years. The incidence rate ratio (IRR) was higher in patients with previous severe hypoglycemia (3.71; 2.28–6.04), neuropathy (4.16; 2.14–8.05), long duration (>20 years, 2.96; 1.60–5.45), and on polypharmacy (1.24; 1.13–1.36), but it was lower when a complication was present. The IR of symptomatic hypoglycemia was 53.3 events/person-years, with an IRR significantly higher among women or patients with better education, or shorter duration or on pumps. The IRR was lower in patients with higher BMI or neuropathy or aged more than 50 years.
Conclusions
Fewer than 20 % of T1DM patients are free from hypoglycemia, with one in six having experienced at least one severe episode in the last year. The distribution is uneven, with a tendency of episodes to cluster in some patients. Severe and symptomatic episodes have different correlates and reflect different conditions.</description><identifier>ISSN: 0940-5429</identifier><identifier>EISSN: 1432-5233</identifier><identifier>DOI: 10.1007/s00592-015-0713-4</identifier><identifier>PMID: 25670242</identifier><identifier>CODEN: ACDAEZ</identifier><language>eng</language><publisher>Milan: Springer Milan</publisher><subject>Adolescent ; Adult ; Aged ; Body Mass Index ; Diabetes ; Diabetes Mellitus, Type 1 - complications ; Female ; Glycated Hemoglobin A - analysis ; Humans ; Hypoglycemia ; Hypoglycemia - epidemiology ; Internal Medicine ; Male ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Middle Aged ; Original Article ; Retrospective Studies ; Risk Factors ; Surveys and Questionnaires</subject><ispartof>Acta diabetologica, 2015-10, Vol.52 (5), p.845-853</ispartof><rights>Springer-Verlag Italia 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-f18e439dadc3618db60efc6f055375773de441301fc2fa51d24280fc9e220f023</citedby><cites>FETCH-LOGICAL-c405t-f18e439dadc3618db60efc6f055375773de441301fc2fa51d24280fc9e220f023</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00592-015-0713-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00592-015-0713-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25670242$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giorda, Carlo B.</creatorcontrib><creatorcontrib>Ozzello, Alessandro</creatorcontrib><creatorcontrib>Gentile, Sandro</creatorcontrib><creatorcontrib>Aglialoro, Alberto</creatorcontrib><creatorcontrib>Chiambretti, Anna</creatorcontrib><creatorcontrib>Baccetti, Fabio</creatorcontrib><creatorcontrib>Gentile, Francesco M.</creatorcontrib><creatorcontrib>Lucisano, Giuseppe</creatorcontrib><creatorcontrib>Nicolucci, Antonio</creatorcontrib><creatorcontrib>Rossi, Maria Chiara</creatorcontrib><creatorcontrib>HYPOS-1 Study Group of AMD</creatorcontrib><title>Incidence and risk factors for severe and symptomatic hypoglycemia in type 1 diabetes. Results of the HYPOS-1 study</title><title>Acta diabetologica</title><addtitle>Acta Diabetol</addtitle><addtitle>Acta Diabetol</addtitle><description>Objective
Hypoglycemia is common in type 1 diabetes mellitus (T1DM). We aimed to update the incidence of severe and symptomatic hypoglycemia and investigate several correlated factors.
Methods
In this multicenter, observational retrospective study, the data of 206 T1DM patients from a sample of 2,229 consecutive patients seen at 18 diabetes clinics were analyzed. Sociodemographic and clinical characteristics, severe hypoglycemia in the past 12 months, and symptomatic hypoglycemia in the past 4 weeks were recorded with a self-report questionnaire and a clinical form during a routine visit. Poisson multivariate models were applied.
Results
A minority of patients accounted for the majority of both severe and symptomatic episodes. The incidence rate (IR) of severe hypoglycemia was 0.49 (0.40–0.60) events/person-years. The incidence rate ratio (IRR) was higher in patients with previous severe hypoglycemia (3.71; 2.28–6.04), neuropathy (4.16; 2.14–8.05), long duration (>20 years, 2.96; 1.60–5.45), and on polypharmacy (1.24; 1.13–1.36), but it was lower when a complication was present. The IR of symptomatic hypoglycemia was 53.3 events/person-years, with an IRR significantly higher among women or patients with better education, or shorter duration or on pumps. The IRR was lower in patients with higher BMI or neuropathy or aged more than 50 years.
Conclusions
Fewer than 20 % of T1DM patients are free from hypoglycemia, with one in six having experienced at least one severe episode in the last year. The distribution is uneven, with a tendency of episodes to cluster in some patients. Severe and symptomatic episodes have different correlates and reflect different conditions.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Body Mass Index</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Female</subject><subject>Glycated Hemoglobin A - analysis</subject><subject>Humans</subject><subject>Hypoglycemia</subject><subject>Hypoglycemia - epidemiology</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surveys and Questionnaires</subject><issn>0940-5429</issn><issn>1432-5233</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkUtrFUEQRhtRzE30B7iRBjduJlb1487MUkJMAoGIj4WroW93dTJxHteuHmH-vXOdKCIIrmpR5_uK4gjxAuEUAco3DGBrVQDaAkrUhXkkNmi0KqzS-rHYQG2gsEbVR-KY-R4AVamrp-JI2W0JyqiN4KvBt4EGT9INQaaWv8rofB4TyzgmyfSd0rrjud_nsXe59fJu3o-33eypb51sB5nnPUmUoXU7ysSn8gPx1GWWY5T5juTll_c3HwuUnKcwPxNPouuYnj_ME_H53fmns8vi-ubi6uztdeEN2FxErMjoOrjg9RarsNsCRb-NYK0ubVnqQMagBoxeRWcxLA9VEH1NSkEEpU_E67V3n8ZvE3Fu-pY9dZ0baJy4wbKyStUa4T9QRGss6npBX_2F3o9TGpZHflJY6RIPFK6UTyNzotjsU9u7NDcIzUFes8prFnnNQV5jlszLh-Zp11P4nfhlawHUCvCyGm4p_XH6n60_AOTqork</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Giorda, Carlo B.</creator><creator>Ozzello, Alessandro</creator><creator>Gentile, Sandro</creator><creator>Aglialoro, Alberto</creator><creator>Chiambretti, Anna</creator><creator>Baccetti, Fabio</creator><creator>Gentile, Francesco M.</creator><creator>Lucisano, Giuseppe</creator><creator>Nicolucci, Antonio</creator><creator>Rossi, Maria Chiara</creator><general>Springer Milan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20151001</creationdate><title>Incidence and risk factors for severe and symptomatic hypoglycemia in type 1 diabetes. Results of the HYPOS-1 study</title><author>Giorda, Carlo B. ; Ozzello, Alessandro ; Gentile, Sandro ; Aglialoro, Alberto ; Chiambretti, Anna ; Baccetti, Fabio ; Gentile, Francesco M. ; Lucisano, Giuseppe ; Nicolucci, Antonio ; Rossi, Maria Chiara</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-f18e439dadc3618db60efc6f055375773de441301fc2fa51d24280fc9e220f023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Body Mass Index</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Female</topic><topic>Glycated Hemoglobin A - analysis</topic><topic>Humans</topic><topic>Hypoglycemia</topic><topic>Hypoglycemia - epidemiology</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Giorda, Carlo B.</creatorcontrib><creatorcontrib>Ozzello, Alessandro</creatorcontrib><creatorcontrib>Gentile, Sandro</creatorcontrib><creatorcontrib>Aglialoro, Alberto</creatorcontrib><creatorcontrib>Chiambretti, Anna</creatorcontrib><creatorcontrib>Baccetti, Fabio</creatorcontrib><creatorcontrib>Gentile, Francesco M.</creatorcontrib><creatorcontrib>Lucisano, Giuseppe</creatorcontrib><creatorcontrib>Nicolucci, Antonio</creatorcontrib><creatorcontrib>Rossi, Maria Chiara</creatorcontrib><creatorcontrib>HYPOS-1 Study Group of AMD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Acta diabetologica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giorda, Carlo B.</au><au>Ozzello, Alessandro</au><au>Gentile, Sandro</au><au>Aglialoro, Alberto</au><au>Chiambretti, Anna</au><au>Baccetti, Fabio</au><au>Gentile, Francesco M.</au><au>Lucisano, Giuseppe</au><au>Nicolucci, Antonio</au><au>Rossi, Maria Chiara</au><aucorp>HYPOS-1 Study Group of AMD</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence and risk factors for severe and symptomatic hypoglycemia in type 1 diabetes. Results of the HYPOS-1 study</atitle><jtitle>Acta diabetologica</jtitle><stitle>Acta Diabetol</stitle><addtitle>Acta Diabetol</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>52</volume><issue>5</issue><spage>845</spage><epage>853</epage><pages>845-853</pages><issn>0940-5429</issn><eissn>1432-5233</eissn><coden>ACDAEZ</coden><abstract>Objective
Hypoglycemia is common in type 1 diabetes mellitus (T1DM). We aimed to update the incidence of severe and symptomatic hypoglycemia and investigate several correlated factors.
Methods
In this multicenter, observational retrospective study, the data of 206 T1DM patients from a sample of 2,229 consecutive patients seen at 18 diabetes clinics were analyzed. Sociodemographic and clinical characteristics, severe hypoglycemia in the past 12 months, and symptomatic hypoglycemia in the past 4 weeks were recorded with a self-report questionnaire and a clinical form during a routine visit. Poisson multivariate models were applied.
Results
A minority of patients accounted for the majority of both severe and symptomatic episodes. The incidence rate (IR) of severe hypoglycemia was 0.49 (0.40–0.60) events/person-years. The incidence rate ratio (IRR) was higher in patients with previous severe hypoglycemia (3.71; 2.28–6.04), neuropathy (4.16; 2.14–8.05), long duration (>20 years, 2.96; 1.60–5.45), and on polypharmacy (1.24; 1.13–1.36), but it was lower when a complication was present. The IR of symptomatic hypoglycemia was 53.3 events/person-years, with an IRR significantly higher among women or patients with better education, or shorter duration or on pumps. The IRR was lower in patients with higher BMI or neuropathy or aged more than 50 years.
Conclusions
Fewer than 20 % of T1DM patients are free from hypoglycemia, with one in six having experienced at least one severe episode in the last year. The distribution is uneven, with a tendency of episodes to cluster in some patients. Severe and symptomatic episodes have different correlates and reflect different conditions.</abstract><cop>Milan</cop><pub>Springer Milan</pub><pmid>25670242</pmid><doi>10.1007/s00592-015-0713-4</doi><tpages>9</tpages></addata></record> |
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subjects | Adolescent Adult Aged Body Mass Index Diabetes Diabetes Mellitus, Type 1 - complications Female Glycated Hemoglobin A - analysis Humans Hypoglycemia Hypoglycemia - epidemiology Internal Medicine Male Medicine Medicine & Public Health Metabolic Diseases Middle Aged Original Article Retrospective Studies Risk Factors Surveys and Questionnaires |
title | Incidence and risk factors for severe and symptomatic hypoglycemia in type 1 diabetes. Results of the HYPOS-1 study |
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