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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Veröffentlicht in:Acta diabetologica 2015-10, Vol.52 (5), p.845-853
Hauptverfasser: Giorda, Carlo B., Ozzello, Alessandro, Gentile, Sandro, Aglialoro, Alberto, Chiambretti, Anna, Baccetti, Fabio, Gentile, Francesco M., Lucisano, Giuseppe, Nicolucci, Antonio, Rossi, Maria Chiara
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container_issue 5
container_start_page 845
container_title Acta diabetologica
container_volume 52
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
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Results of the HYPOS-1 study</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Giorda, Carlo B. ; Ozzello, Alessandro ; Gentile, Sandro ; Aglialoro, Alberto ; Chiambretti, Anna ; Baccetti, Fabio ; Gentile, Francesco M. ; Lucisano, Giuseppe ; Nicolucci, Antonio ; Rossi, Maria Chiara</creator><creatorcontrib>Giorda, Carlo B. ; Ozzello, Alessandro ; Gentile, Sandro ; Aglialoro, Alberto ; Chiambretti, Anna ; Baccetti, Fabio ; Gentile, Francesco M. ; Lucisano, Giuseppe ; Nicolucci, Antonio ; Rossi, Maria Chiara ; HYPOS-1 Study Group of AMD</creatorcontrib><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 (&gt;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. 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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 (&gt;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. 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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 (&gt;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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