Severe Hypoglycemia Identifies Vulnerable Patients With Type 2 Diabetes at Risk for Premature Death and All-Site Cancer: The Hong Kong Diabetes Registry
| Autor: | Alice P.S. Kong, Ronald C.W. Ma, Wing-Yee So, Kitty K.T. Cheung, Juliana C.N. Chan, Rose Z.W. Ting, Michael H.M. Chan, Risa Ozaki, Chung Shun Ho, Chun-Chung Chow, Andrea O.Y. Luk, Xilin Yang |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Endocrinology Diabetes and Metabolism Type 2 diabetes Hypoglycemia Severity of Illness Index chemistry.chemical_compound Risk Factors Interquartile range Neoplasms Diabetes mellitus Internal medicine Internal Medicine medicine Humans Aged Advanced and Specialized Nursing Mortality Premature business.industry Hazard ratio Middle Aged medicine.disease Endocrinology Diabetes Mellitus Type 2 chemistry Albuminuria Hong Kong Female Glycated hemoglobin medicine.symptom business Kidney disease |
| Zdroj: | Diabetes Care. 37:1024-1031 |
| ISSN: | 1935-5548 0149-5992 |
| Popis: | OBJECTIVE We examined the associations of clinical profiles in type 2 diabetic patients who developed severe hypoglycemia and their clinical outcomes, including death and all-site cancer. RESEARCH DESIGN AND METHODS A consecutive cohort of 8,767 type 2 diabetic patients with and without severe hypoglycemia in the 12 months before enrollment were recruited between 1995 and 2007, with follow-up until 2009. Severe hypoglycemia was defined by ICD-9 codes as hospitalizations resulting from hypoglycemia. Cox proportional hazards regression was used to calculate the hazard ratio (HR) and 95% CIs of clinical factors collected at enrollment for severe hypoglycemia. RESULTS In this cohort, mean age was 57.4 (SD 13.2) years and median disease duration of diabetes was 5 (interquartile range [IQR] 1–11) years. During a median follow-up of 6.71 (IQR 3.47–10.38) years, 235 patients had severe hypoglycemia (incidence 3.96 [95% CI 3.45–4.46] per 1,000 patient-years). At enrollment, patients with and without severe hypoglycemia had similar cancer rates. During follow-up, patients with severe hypoglycemia had a higher incidence of all-site cancer (13.4 vs. 6.4%, P < 0.0001) and mortality (32.8 vs. 11.2%, P < 0.0001) than those without severe hypoglycemia. After adjusting for confounders, old age, low BMI, high glycated hemoglobin, low triglyceride (TG), low LDL cholesterol (LDL-C), albuminuria, and chronic kidney disease were independent predictors for severe hypoglycemia. CONCLUSIONS In type 2 diabetes, severe hypoglycemia is associated with advanced age, renal dysfunction, poor glycemic control, and cancer subphenotypes (low BMI, low LDL-C, and low TG). |
| Databáze: | OpenAIRE |
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