Associations between glucagon prescribing, hospital admissions for hypoglycaemia and continuous glucose monitoring metrics in adults with type 1 diabetes.

Autor: Stimson RH; Edinburgh Centre for Endocrinology & Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK; University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK., Dover AR; Edinburgh Centre for Endocrinology & Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK., Strachan MWJ; Edinburgh Centre for Endocrinology & Diabetes, Western General Hospital, Edinburgh, UK., Wright RJ; Edinburgh Centre for Endocrinology & Diabetes, St John's Hospital, Edinburgh, UK., Lyall MJ; Edinburgh Centre for Endocrinology & Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK., Jeeyavudeen MS; Edinburgh Centre for Endocrinology & Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK., Forbes S; Edinburgh Centre for Endocrinology & Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK; University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK., Gibb FW; Edinburgh Centre for Endocrinology & Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK; University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. Electronic address: fraser.gibb@ed.ac.uk.
Jazyk: angličtina
Zdroj: Journal of diabetes and its complications [J Diabetes Complications] 2023 Sep; Vol. 37 (9), pp. 108561. Date of Electronic Publication: 2023 Jul 22.
DOI: 10.1016/j.jdiacomp.2023.108561
Abstrakt: Aims: To assess features associated with glucagon prescribing and hospital admissions with hypoglycaemia in type one diabetes.
Methods: Observational study of 4462 adults. Outcome measures were features associated with glucagon prescriptions and predictors of hospital admissions with hypoglycaemia and high levels of glucagon prescribing.
Results: 74 % did not collect any glucagon prescriptions and 2.7 % collected >6 over 3.5 years. Hospital admission with hypoglycaemia (P = 0.032), impaired awareness (P = 0.049) and female sex (P < 0.001) were associated with glucagon collection. More frequent prescribing of glucagon was associated with diabetes duration (P < 0.001) and socioeconomic deprivation (P < 0.001). Higher average glucose (P = 0.047), higher time above 13.9 mM (P = 0.008) and higher SD (P = 0.002) were associated with glucagon prescribing. Diabetes duration (P < 0.001) and HbA1c (P < 0.001) were higher in people with hospitalised hypoglycaemia. Higher time above 13.9 mM (P = 0.004) and SD glucose (P < 0.001) were most clearly associated with hospitalised hypoglycaemia.
Conclusions: A minority of people with type 1 diabetes have access to glucagon suggesting more could be done to better target this treatment. Individuals with risk factors and those with frequent glucagon prescriptions should be identified for interventions known to reduce hypoglycaemia.
Competing Interests: Declaration of competing interest Dr. Fraser W Gibb has received speaker fees from Novo Nordisk, Lilly, Abbott and Insulet. Dr. Anna R Dover has received speaker fees from Abbott.
(Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: